Maayan Lawrence, Paykina Natalya, Fried Jane, Strauss Tara, Gugga S Sonia, Greenhill Laurence
Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York 10962, USA.
J Child Adolesc Psychopharmacol. 2009 Apr;19(2):147-53. doi: 10.1089/cap.2008.053.
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.
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.
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.
B-MPH was safe and effective for the treatment of ADHD in the 4- and 5-year-olds participating in this study.
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。
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。
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。
对于参与本研究的4至5岁儿童,B-MPH治疗ADHD安全有效。