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用珠状哌甲酯对4至5岁儿童注意力缺陷/多动障碍进行开放标签治疗。

The open-label treatment of attention-deficit/hyperactivity disorder in 4- and 5-year-old children with beaded methylphenidate.

作者信息

Maayan Lawrence, Paykina Natalya, Fried Jane, Strauss Tara, Gugga S Sonia, Greenhill Laurence

机构信息

Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York 10962, USA.

出版信息

J Child Adolesc Psychopharmacol. 2009 Apr;19(2):147-53. doi: 10.1089/cap.2008.053.

Abstract

OBJECTIVE

The aim of this study was to assess the effectiveness and tolerability of a long-acting methylphenidate (MPH) formulation, beaded MPH (B-MPH), for treatment of attention-deficit/hyperactivity disorder (ADHD) in 4- and 5-year-old children.

METHOD

Eleven children (9 boys and 2 girls) with ADHD received 4 weeks of B-MPH treatment in a single-site, open-label pilot study. Medication dosing was flexible, with titration to a maximum of 30 mg/day. A brief education session on behavior management was offered to parents at each treatment visit.

RESULTS

Subjects experienced a mean decrease of 1.09 (standard deviation [SD]=0.73, p<0.01) on the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) ADHD composite score to an end point of 1.18 (SD=0.64). Subjects demonstrated mean decreases in scores of inattention of 1.01 (SD=0.85, p<0.01) and in hyperactivity/impulsivity of 1.17 (SD=0.74, p<0.01), with end point scores of 1.10 (SD=0.61) and 1.26 (SD=0.77), respectively. The Clinical Global Impressions-Severity (CGI-S) scale showed a statistically significant improvement from a baseline mean of 5 to the final visit mean of 3.36 (p<0.01). At the final visit, the mean daily B-MPH dose was 17.73 mg. Subjects did not experience any statistically significant changes in weight, blood pressure, or pulse during the study. The most common adverse event was decreased appetite.

CONCLUSION

B-MPH was safe and effective for the treatment of ADHD in the 4- and 5-year-olds participating in this study.

摘要

目的

本研究旨在评估长效哌甲酯(MPH)制剂,即串珠状MPH(B-MPH)治疗4至5岁儿童注意力缺陷多动障碍(ADHD)的有效性和耐受性。

方法

在一项单中心、开放标签的试点研究中,11名患有ADHD的儿童(9名男孩和2名女孩)接受了4周的B-MPH治疗。药物剂量灵活,最大滴定至30毫克/天。在每次治疗就诊时,为家长提供一次关于行为管理的简短教育课程。

结果

在斯旺森、诺兰和佩勒姆问卷(SNAP-IV)ADHD综合评分上,受试者平均下降了1.09(标准差[SD]=0.73,p<0.01),终点值为1.18(SD=0.64)。受试者在注意力不集中方面的得分平均下降了1.01(SD=0.85,p<0.01),在多动/冲动方面的得分平均下降了1.17(SD=0.74,p<0.01),终点得分分别为1.10(SD=0.61)和1.26(SD=0.77)。临床总体印象-严重程度(CGI-S)量表显示,从基线均值5到最后一次就诊均值3.36有统计学显著改善(p<0.01)。在最后一次就诊时,B-MPH的平均日剂量为17.73毫克。在研究期间,受试者的体重、血压或脉搏没有出现任何统计学显著变化。最常见的不良事件是食欲下降。

结论

对于参与本研究的4至5岁儿童,B-MPH治疗ADHD安全有效。

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