Baptista-Neto Lourival, Dodds Alice, Rao Sneha, Whitney Jane, Torres Alcy, Gonzalez-Heydrich Joseph
Children's Hospital of Boston, Department of Psychiatry, 300 Longwood Avenue, Boston, MA 02115, USA.
Expert Opin Investig Drugs. 2008 Jan;17(1):77-84. doi: 10.1517/13543784.17.1.77.
Methylphenidate (MPH) is one of the most commonly prescribed medications to treat attention deficit hyperactivity disorder (ADHD). Despite the elevated rates of ADHD in children with epilepsy, few studies have examined the use of MPH in this population. Case reports have warned about new-onset seizures in patients treated with MPH, and drug-drug interactions between MPH and antiepileptic drugs (AEDs), as well as antidepressants. However, retrospective chart reviews, open-label trials and controlled trials of MPH in patients with epilepsy and ADHD have noted significant improvements in ADHD symptoms without an exacerbation of seizures or an adverse effect on AED serum levels. This paper reviews the chemistry and mechanisms of action of MPH, as well as preclinical, premarketing clinical trials and postmarketing data relevant to its use in patients with ADHD and epilepsy.
哌甲酯（MPH）是治疗注意力缺陷多动障碍（ADHD）最常用的处方药之一。尽管癫痫患儿中ADHD的发病率较高，但很少有研究探讨MPH在该人群中的使用情况。病例报告曾警告使用MPH的患者会出现新发癫痫，以及MPH与抗癫痫药物（AED）之间的药物相互作用，还有与抗抑郁药的相互作用。然而，对癫痫合并ADHD患者使用MPH的回顾性病历审查、开放标签试验和对照试验均指出，ADHD症状有显著改善，且癫痫未加重，对AED血清水平也无不良影响。本文综述了MPH的化学性质和作用机制，以及与它在ADHD和癫痫患者中使用相关的临床前、上市前临床试验和上市后数据。
