Ratner Sharon, Laor Nathaniel, Bronstein Yifat, Weizman Abraham, Toren Paz
Tel Aviv-Brull Community Mental Health Center, Israel.
J Am Acad Child Adolesc Psychiatry. 2005 May;44(5):428-33. doi: 10.1097/01.chi.0000155327.30017.8c.
This open-label study assessed the effectiveness of reboxetine, a selective norepinephrine reuptake inhibitor, in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) resistant to a previous methylphenidate trial.
Thirty-one child and adolescent outpatients, aged 8 to 18 (mean age, 11.7; SD = 2.87) years, diagnosed with ADHD were enrolled in a 6-week open-label study. Assessments included rater-administered scales (DSM-IV ADHD Scale; Clinical Global Impressions Scale), parent-administered scales (the Abbreviated Conners Rating Scale), and self-administered-scales for the evaluation of depressive (Children's Depression Inventory) and anxiety (the Revised Children's Manifest Anxiety Scale) symptoms. Reboxetine was initiated and maintained at a dose of 4 mg/day.
A significant decrease in ADHD symptoms, on all scales measured, was noted. Adverse effects were relatively mild and transient. The most common adverse effects were drowsiness/sedation and gastrointestinal complaints.
The results of the current open-label study suggest the effectiveness of reboxetine in the treatment of ADHD in methylphenidate-resistant children and adolescents. Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test the efficacy of reboxetine in ADHD.
本开放标签研究评估了选择性去甲肾上腺素再摄取抑制剂瑞波西汀对先前使用哌甲酯治疗无效的注意缺陷/多动障碍(ADHD)儿童和青少年的疗效。
31名年龄在8至18岁(平均年龄11.7岁;标准差=2.87)、被诊断为ADHD的儿童和青少年门诊患者参加了一项为期6周的开放标签研究。评估包括评估者评定量表(《精神疾病诊断与统计手册》第四版ADHD量表;临床总体印象量表)、家长评定量表(简化版康纳斯评定量表)以及用于评估抑郁(儿童抑郁量表)和焦虑(修订版儿童显性焦虑量表)症状的自我评定量表。瑞波西汀起始剂量为4mg/天,并维持该剂量。
在所测量的所有量表上,ADHD症状均显著减轻。不良反应相对较轻且为一过性。最常见的不良反应是嗜睡/镇静和胃肠道不适。
当前开放标签研究的结果表明,瑞波西汀对哌甲酯治疗无效的ADHD儿童和青少年有效。需要进行双盲、安慰剂和活性对照研究以严格检验瑞波西汀治疗ADHD的疗效。