Ramos-Quiroga J Antoni, Corominas Margarida, Castells Xavier, Bosch Rosa, Casas Miguel
Adult ADHD Program, Department of Psychiatry, Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain.
Expert Rev Neurother. 2009 Aug;9(8):1121-31. doi: 10.1586/ern.09.65.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood. It continues into adulthood in up to 65% of patients. Methylphenidate (MPH) is one of the most commonly used pharmacological treatments for ADHD. The osmotic-release oral system (OROS) formulation of MPH is an extended-release pharmaceutical form that delivers MPH in a controlled manner over a 12-h period, allowing management of symptoms for a full day. OROS-MPH has many advantages over immediate-release MPH, such as avoiding clinical rebound, being easy to take, increasing treatment adherence and reducing the risk of abuse. OROS-MPH has been approved in the USA and Europe for the treatment of ADHD in children, but it has only been approved for the treatment of adults in the USA and Canada. This review summarizes evidence from various clinical studies assessing the efficacy and safety of OROS-MPH in different clinical samples of adults with ADHD, including samples with the most common comorbidities found in ADHD patients. The studies are classified according to their design characteristics as randomized, controlled trials or open trials. Data on dosing, treatment adherence and other clinical parameters relevant for the use of OROS-MPH in adults with ADHD are also reported and discussed.
注意缺陷多动障碍（ADHD）是儿童期最常见的行为障碍之一。高达65%的患者会持续到成年期。哌甲酯（MPH）是治疗ADHD最常用的药物之一。MPH的渗透泵控释口服系统（OROS）制剂是一种缓释剂型，能在12小时内以可控方式释放MPH，从而实现一整天的症状控制。与速释MPH相比，OROS-MPH有许多优势，如避免临床反跳、服用方便、提高治疗依从性以及降低滥用风险。OROS-MPH在美国和欧洲已被批准用于治疗儿童ADHD，但仅在美国和加拿大被批准用于治疗成人ADHD。本综述总结了各种临床研究的证据，这些研究评估了OROS-MPH在不同ADHD成人临床样本中的疗效和安全性，包括ADHD患者中最常见合并症的样本。这些研究根据其设计特点分为随机对照试验或开放试验。还报告并讨论了与成人ADHD使用OROS-MPH相关的给药、治疗依从性和其他临床参数的数据。
