Boon-yasidhi Vitharon, Kim Young S, Scahill Lawrence
Division of Child Psychiatry, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2005 Nov;88 Suppl 8:S156-62.
To evaluate the efficacy and safety of guanfacine in children with attention-deficit hyperactivity disorder (ADHD) and tic disorders.
Twenty-five medication-free subjects (23 males and 2 females), aged 7-16 (mean = 10.6 +/- 2.0) years participated in an 8-week open-label guanfacine study. Subjects were recruited from a specialty clinic for children with tic disorders over a four-year period. Eligibility criteria included presence of ADHD (any type), a tic disorder (any type), and being medication free for two weeks. Outcome measures included the Hyperactivity Index of the Conners Parent Questionnaire, the teacher-rated ADHD Rating Scale, and the Yale Global Tic Severity Scale (YGTSS).
All subjects met criteria for ADHD (combined type N = 22; predominantly inattentive type N = 3) and a tic disorder (Tourette's Disorder N = 20; chronic motor tic disorder N = 5). At an average dose of 2.0 +/- 0.6 mg/ day, guanfacine was associated with mean improvement of 27% on the Hyperactivity Index (N = 25; t = 4.61; p < 0.001), 32% on the total score of the teacher-rated ADHD Scale (N = 19; t = 5.27; p < 0.001), and 39% on the total tic severity scale (N = 19; t = 4.17; p < 0.001). Mild and statistically insignificant decreases in blood pressure and pulse were observed in the sample as a whole. Five subjects had endpoint systolic blood pressure below 1 SD from their age and gender norms.
Results of this open-label study add to the growing data base on the safety and efficacy of guanfacine in children with ADHD and tic disorders.
评估胍法辛治疗注意缺陷多动障碍（ADHD）合并抽动障碍儿童的疗效和安全性。
25名未服用过药物的受试者（23名男性，2名女性），年龄7至16岁（平均10.6±2.0岁），参与了一项为期8周的胍法辛开放标签研究。受试者在四年时间里从一家抽动障碍儿童专科诊所招募。纳入标准包括患有ADHD（任何类型）、抽动障碍（任何类型）且两周内未服用药物。观察指标包括康纳斯父母问卷中的多动指数、教师评定的ADHD评定量表以及耶鲁综合抽动严重程度量表（YGTSS）。
所有受试者均符合ADHD标准（混合型22例；主要为注意力不集中型3例）和抽动障碍标准（妥瑞氏症20例；慢性运动性抽动障碍5例）。胍法辛平均剂量为2.0±0.6毫克/天，与多动指数平均改善27%相关（n = 25；t = 4.61；p < 0.001），教师评定的ADHD量表总分改善32%（n = 19；t = 5.27；p < 0.001），抽动严重程度总量表改善39%（n = 19；t = 4.17；p < 0.001）。总体样本中观察到血压和脉搏有轻微且无统计学意义的下降。5名受试者的收缩压终点值低于其年龄和性别正常范围的1个标准差。
这项开放标签研究的结果进一步丰富了胍法辛治疗ADHD合并抽动障碍儿童安全性和有效性的数据库。
