Siddall O'Rita M
College of Pharmacy, Xavier University, New Orleans, LA, USA.
Ann Pharmacother. 2005 Jul-Aug;39(7-8):1309-13. doi: 10.1345/aph.1E637. Epub 2005 May 24.
To review literature regarding the effectiveness of methylphenidate in the management of the cognitive and behavioral changes observed following traumatic brain injury (TBI).
A literature search was conducted using the following databases: MEDLINE (1966-June 2004); Cochrane Central Register of Controlled Trials, fourth quarter 2004 (1988-June 2004); and International Pharmaceutical Abstracts (1970-June 2004). Methylphenidate and brain injury were the key search terms used. Limits were set to include clinical trial publications, human subjects, and English language.
Ten clinical trials evaluating the efficacy and safety of methylphenidate in pediatric and adult patients with TBI are reviewed. Improvements in different aspects of cognition and behavior were evaluated before, during, and after treatment with methylphenidate. The results demonstrated that methylphenidate is likely to improve memory, attention, concentration, and mental processing, but its effects on behavior have not been determined.
Larger, double-blind, placebo-controlled studies are needed to determine optimal doses, during which phase of recovery to begin treatment, length of treatment, and long-term effects for patients with mild, moderate, and severe TBI.
回顾有关哌甲酯治疗创伤性脑损伤（TBI）后认知及行为改变有效性的文献。
使用以下数据库进行文献检索：医学索引数据库（1966年 - 2004年6月）；Cochrane对照试验中心注册库，2004年第四季度（1988年 - 2004年6月）；以及国际药学文摘（1970年 - 2004年6月）。检索关键词为哌甲酯和脑损伤。设定检索限制条件为纳入临床试验出版物、人类受试者及英文文献。
回顾了10项评估哌甲酯对小儿及成年TBI患者疗效及安全性的临床试验。评估了在使用哌甲酯治疗前、治疗期间及治疗后认知和行为不同方面的改善情况。结果表明，哌甲酯可能改善记忆、注意力、专注力及心理加工能力，但其对行为的影响尚未确定。
需要开展更大规模的双盲、安慰剂对照研究，以确定最佳剂量、开始治疗的恢复阶段、治疗时长以及对轻度、中度和重度TBI患者的长期影响。
