Hazell Philip L, Stuart John E
University of Newcastle, New South Wales, Australia.
J Am Acad Child Adolesc Psychiatry. 2003 Aug;42(8):886-94. doi: 10.1097/01.CHI.0000046908.27264.00.
To compare clonidine with placebo added to ongoing psychostimulant therapy for the treatment of attention-deficit/hyperactivity disorder with comorbid oppositional defiant disorder or conduct disorder.
Children 6 to 14 years of age recruited through 2000 to 2001 were randomized to receive clonidine syrup 0.10 to 0.20 mg/day (n = 38) or placebo (n = 29) for 6 weeks. Primary outcome measures were the Conduct and Hyperactive Index subscales of the parent-report Conners Behavior Checklist. Side effects were monitored using physiological measures and the Barkley Side Effect Rating Scale.
Evaluable patient analysis showed that significantly more clonidine-treated children than controls were responders on the Conduct scale (21 of 37 versus 6 of 29; chi2(1) = 8.75, p <.01) but not the Hyperactive Index (13 of 37 versus 5 of 29). Compared with placebo, clonidine was associated with a greater reduction in systolic blood pressure measured standing and with transient sedation and dizziness. Clonidine-treated individuals had a greater reduction in a number of unwanted effects associated with psychostimulant treatment compared with placebo.
The findings support the continued use of clonidine in combination with psychostimulant medication to reduce conduct symptoms associated with attention-deficit/hyperactivity disorder. Treatment is well tolerated and unwanted effects are transient.
比较可乐定与安慰剂添加到正在进行的精神兴奋剂治疗中，用于治疗伴有对立违抗障碍或品行障碍的注意力缺陷/多动障碍的效果。
2000年至2001年招募的6至14岁儿童被随机分为两组，一组接受0.10至0.20毫克/天的可乐定糖浆治疗（n = 38），另一组接受安慰剂治疗（n = 29），为期6周。主要结局指标是家长报告的康纳斯行为检查表中的品行和多动指数子量表。使用生理指标和巴克利副作用评定量表监测副作用。
可评估患者分析显示，在品行量表上，接受可乐定治疗的儿童中有反应的人数显著多于对照组（37人中的21人对29人中的6人；χ2(1) = 8.75，p <.01），但在多动指数上并非如此（37人中的13人对29人中的5人）。与安慰剂相比，可乐定与站立时测量的收缩压更大幅度降低、短暂镇静和头晕有关。与安慰剂相比，接受可乐定治疗的个体与精神兴奋剂治疗相关的一些不良影响有更大程度的减轻。
研究结果支持继续将可乐定与精神兴奋剂药物联合使用，以减轻与注意力缺陷/多动障碍相关的品行症状。治疗耐受性良好，不良影响是短暂的。
