Troost Pieter W, Steenhuis Mark-Peter, Tuynman-Qua Hanneke G, Kalverdijk Luuk J, Buitelaar Jan K, Minderaa Ruud B, Hoekstra Pieter J
Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands.
J Child Adolesc Psychopharmacol. 2006 Oct;16(5):611-9. doi: 10.1089/cap.2006.16.611.
This pilot study examined the effects of atomoxetine on attention-deficit/hyperactivity disorder (ADHD) symptoms and autistic features in children with pervasive developmental disorders (PDD).
Twelve children (aged 6-14 years) with PDD accompanied by ADHD symptoms entered a 10-week open-label study with atomoxetine (1.19 +/- 0.41 mg/kg/day). Response was assessed by using parent and clinician rating scales with change in the ADHD-Rating Scale (ADHDRS) as primary outcome measure.
Atomoxetine reduced ADHD-symptoms as measured by the ADHDRS (44% decrease vs. baseline, p < 0.003), the Conners' Parent Rating Scale-R:S (CPRS-R) (25% in the subscale "Cognitive Problems," p < 0.028; 32% in "Hyperactivity," p < 0.030; and 23% in "ADHD index," p < 0.023). We found a reduction of 21% (p = 0.071) for changes in the subscale "Hyperactivity" of the Aberrant Behavior Checklist (ABC). No change was found in any of the other ABC subscales, nor in the subscale "Oppositional" of the CPRS-R. Five patients (42%) discontinued because of side effects. Gastrointestinal symptoms, irritability, sleep problems, and fatigue were the most frequent side effects.
These preliminary findings indicate that atomoxetine may be a promising new agent in the treatment of ADHD symptoms in children with PDD. However, children with PDD may have a higher vulnerability for some of the known side-effects of atomoxetine.
本初步研究探讨了托莫西汀对广泛性发育障碍(PDD)儿童注意力缺陷多动障碍(ADHD)症状及自闭症特征的影响。
12名伴有ADHD症状的PDD儿童(年龄6 - 14岁)进入一项为期10周的托莫西汀开放标签研究(剂量为1.19±0.41毫克/千克/天)。通过家长和临床医生评定量表评估反应,以ADHD评定量表(ADHDRS)的变化作为主要结局指标。
托莫西汀降低了ADHDRS所测量的ADHD症状(与基线相比降低了44%,p < 0.003),以及康纳斯家长评定量表-R:S(CPRS-R)(“认知问题”子量表降低了25%,p < 0.028;“多动”子量表降低了32%,p < 0.030;“ADHD指数”降低了23%,p < 0.023)。我们发现异常行为检查表(ABC)“多动”子量表的变化降低了21%(p = 0.071)。ABC的任何其他子量表以及CPRS-R的“对立违抗”子量表均未发现变化。5名患者(42%)因副作用停药。胃肠道症状、易怒、睡眠问题和疲劳是最常见的副作用。
这些初步研究结果表明,托莫西汀可能是治疗PDD儿童ADHD症状的一种有前景的新药。然而,PDD儿童可能对托莫西汀的一些已知副作用更易敏感。