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[关于托莫西汀的当前证据。治疗注意力缺陷多动障碍的一种治疗选择]

[Current evidence about atomoxetine. A therapeutic alternative for the treatment of attention deficit hyperactivity disorder].

作者信息

Velásquez-Tirado J D, Peña J A

机构信息

Psiquiatría de Enlace, Universidad El Bosque-Clínica Reina Sofía, Bogotá, Colombia.

出版信息

Rev Neurol. 2005;41(8):493-500.

Abstract

AIMS

To conduct an updated review of the mechanisms of action, pharmacokinetics, clinical effectiveness and safety of atomoxetine in the treatment of the symptoms of ADHD.

DEVELOPMENT

Atomoxetine is the first of the group of non-stimulant drugs to be approved by the US Food and Drug Administration to treat this disorder in children, adolescents and adults. Atomoxetine has a direct effect on noradrenalin and dopamine concentrations by exerting a strong and highly selective inhibiting action on the pre-synaptic noradrenalin transporter, with a minimum affinity for other transporters and receptors. After adjustment of the dosage for body weight, the pharmacokinetic parameters are similar across all age and gender groups. Maximal plasma concentration is reached one to two hours after oral administration. Data concerning the effectiveness and safety from the clinical trials and studies reported in the literature are discussed.

CONCLUSIONS

Atomoxetine is an effective and well-tolerated drug when used for the pharmacological treatment of ADHD symptoms. Despite being a drug that has only recently been developed, evidence from the large number of comparative studies that have been carried out endorse its widespread use in the treatment of this syndrome.

摘要

目的

对托莫西汀治疗注意缺陷多动障碍(ADHD)症状的作用机制、药代动力学、临床疗效及安全性进行更新综述。

进展

托莫西汀是美国食品药品监督管理局批准用于治疗儿童、青少年及成人该疾病的非兴奋剂类药物中的首个药物。托莫西汀通过对突触前去甲肾上腺素转运体发挥强大且高度选择性的抑制作用,对去甲肾上腺素和多巴胺浓度产生直接影响,对其他转运体和受体的亲和力极小。根据体重调整剂量后,所有年龄和性别组的药代动力学参数相似。口服给药后1至2小时达到最大血浆浓度。讨论了文献中报道的临床试验和研究的有效性及安全性数据。

结论

托莫西汀用于ADHD症状的药物治疗时是一种有效且耐受性良好的药物。尽管它是一种最近才研发出的药物,但大量比较研究的证据支持其在该综合征治疗中的广泛应用。

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