Findling Robert L, Childress Ann C, Krishnan Suma, McGough James J
Child and Adolescent Psychiatry, University Hospitals Case Medical Center, Cleveland, Ohio 44106, USA.
CNS Spectr. 2008 Jul;13(7):614-20. doi: 10.1017/s1092852900016898.
Lisdexamfetamine dimesylate (LDX), a prodrug stimulant, is indicated for attention-deficit/hyperactivity disorder (ADHD) in children 6-12 years of age and in adults. In short-term studies, once-daily LDX provided efficacy throughout the day. This study presented here was conducted to assess the long-term safety, tolerability, and effectiveness of LDX in 6- to 12-year-olds with ADHD.
This open-label, multicenter, single-arm study enrolled children with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision criteria for ADHD. Following 1-week screening and washout periods, subjects were titrated to LDX 30, 50, or 70 mg/day over 4 weeks and placed on maintenance treatment for 11 months. The ADHD Rating Scale and Clinical Global Impression-Improvement scale measured effectiveness.
Of 272 subjects receiving LDX, 147 completed the study. Most adverse events were mild to moderate and occurred during the first 4 weeks. There were no clinically meaningful changes in blood pressure or electrocardiographic parameters. From baseline to endpoint, mean ADHD Rating Scale scores improved by 27.2 points (P<.0001). Improvements occurred during each of the first 4 weeks, and were maintained throughout. Based on Clinical Global Impression-Improvement scale scores, >80% of subjects at endpoint and >95% of completers at 12 months were rated "improved."
Long-term 30, 50, and 70 mg/day LDX was generally well tolerated and effective in children with ADHD.
赖右苯丙胺二甲磺酸盐(LDX),一种前体药物兴奋剂,适用于6至12岁儿童及成人的注意力缺陷多动障碍(ADHD)。在短期研究中,每日一次的LDX全天都有疗效。本文所呈现的这项研究旨在评估LDX对6至12岁ADHD儿童的长期安全性、耐受性和有效性。
这项开放标签、多中心、单臂研究纳入了符合《精神疾病诊断与统计手册》第四版文本修订版ADHD标准的儿童。经过1周的筛查和洗脱期后,受试者在4周内滴定至每日30、50或70毫克的LDX,并接受11个月的维持治疗。使用ADHD评定量表和临床总体印象改善量表来衡量有效性。
在272名接受LDX治疗的受试者中,147名完成了研究。大多数不良事件为轻度至中度,且发生在最初4周内。血压或心电图参数没有临床意义上的变化。从基线到终点,ADHD评定量表平均得分提高了27.2分(P<0.0001)。在最初4周的每一周都有改善,并且持续保持。根据临床总体印象改善量表评分,终点时超过80%的受试者以及12个月时超过95%的完成者被评为“改善”。
对于ADHD儿童,长期每日服用30、50和70毫克的LDX通常耐受性良好且有效。