莫达非尼可改善儿童和青少年各亚型注意缺陷多动障碍的症状。

Modafinil improves symptoms of attention-deficit/hyperactivity disorder across subtypes in children and adolescents.

作者信息

Biederman Joseph, Pliszka Steven R

机构信息

Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, MA, USA.

出版信息

J Pediatr. 2008 Mar;152(3):394-9. doi: 10.1016/j.jpeds.2007.07.052. Epub 2007 Oct 24.

Abstract

OBJECTIVE

This secondary analysis evaluated the efficacy of modafinil in children and adolescents by subtype of attention-deficit/hyperactivity disorder (ADHD) using pooled data from 3 double-blind, placebo-controlled studies.

STUDY DESIGN

The patients were boys and girls age 6 to 17 years. ADHD subtype diagnoses (ie, inattentive, hyperactive-impulsive, combined) were based on criteria published in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Patients received modafinil (170 to 425 mg) or placebo once daily for 7 to 9 weeks. Efficacy assessment used the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV) School and Home Versions, Clinical Global Impression of Improvement scale (CGI-I), and Conners' Parent Rating Scale-Revised: Short Form (CPRS-R:S).

RESULTS

A total of 638 patients received modafinil (n = 423) or placebo (n = 215). The inattentive, hyperactive-impulsive, and combined subtypes included 187 (30%), 27 (4%), and 403 (65%) patients, respectively. Modafinil (vs placebo) significantly improved mean total scores for the ADHD-RS-IV School and Home Versions for the inattentive (change from baseline: School, modafinil, -15.7, placebo, -7.1; Home, modafinil, -13.8, placebo, -5.9) and combined subtypes (School, -16.5 vs -8.8; Home, -15.7 vs -7.6). Modafinil was associated with greater improvements on the CGI-I and improved CPRS-R:S subscale scores in inattentive and combined subtypes.

CONCLUSIONS

Modafinil improved ADHD symptoms and behaviors in patients with the inattentive and combined subtypes as determined by teachers, investigators, and parents.

摘要

目的

本二次分析使用来自3项双盲、安慰剂对照研究的汇总数据,按注意力缺陷多动障碍(ADHD)亚型评估莫达非尼在儿童和青少年中的疗效。

研究设计

患者为6至17岁的男孩和女孩。ADHD亚型诊断(即注意力不集中型、多动冲动型、混合型)基于美国精神病学协会《精神疾病诊断与统计手册》第四版(DSM-IV)中公布的标准。患者每天接受一次莫达非尼(170至425毫克)或安慰剂治疗,持续7至9周。疗效评估使用注意力缺陷/多动障碍评定量表-IV(ADHD-RS-IV)学校版和家庭版、临床总体改善印象量表(CGI-I)以及康纳斯父母评定量表修订版:简表(CPRS-R:S)。

结果

共有638例患者接受了莫达非尼(n = 423)或安慰剂(n = 215)治疗。注意力不集中型、多动冲动型和混合型分别包括187例(30%)、27例(4%)和403例(65%)患者。莫达非尼(与安慰剂相比)显著改善了注意力不集中型(与基线相比的变化:学校版,莫达非尼,-15.7,安慰剂,-7.1;家庭版,莫达非尼,-13.8,安慰剂,-5.9)和混合型(学校版,-16.5对-8.8;家庭版,-15.7对-7.6)ADHD-RS-IV学校版和家庭版量表的平均总分。莫达非尼与注意力不集中型和混合型患者在CGI-I上的更大改善以及CPRS-R:S子量表得分的改善相关。

结论

根据教师、研究人员和家长的评估,莫达非尼改善了注意力不集中型和混合型患者的ADHD症状及行为。

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