Elia J, Borcherding B G, Potter W Z, Mefford I N, Rapoport J L, Keysor C S
Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.
Clin Pharmacol Ther. 1990 Jul;48(1):57-66. doi: 10.1038/clpt.1990.118.
To compare the effects of the stimulant drugs dextroamphetamine and methylphenidate on urinary and plasma monoamines and metabolites within the same clinical sample, thirty-one children with attention-deficit disorder with hyperactivity were treated with dextroamphetamine (up to 1.5 mg/kg/day), methylphenidate (up to 3.0 mg/kg/day), and placebo in an 11-week double-blind crossover trial. As expected, both drugs showed striking clinical efficacy, and within a subsample of the group, earlier findings were confirmed, that dextroamphetamine but not methylphenidate lowered urinary and plasma 3-methoxy-4-hydroxyphenylglycol and whole body norepinephrine turnover, and that urinary and plasma concentration of homovanillic acid was unaltered by either drug. Methylphenidate but not dextroamphetamine increased plasma norepinephrine. Urinary epinephrine and metanephrine were increased with both drugs, but this increase did not correlate significantly with clinical improvement.
为了在同一临床样本中比较兴奋剂右旋苯丙胺和哌醋甲酯对尿液及血浆中单胺类物质和代谢产物的影响，在一项为期11周的双盲交叉试验中，对31名患有注意力缺陷多动障碍的儿童分别使用右旋苯丙胺（最高剂量为1.5毫克/千克/天）、哌醋甲酯（最高剂量为3.0毫克/千克/天）和安慰剂进行治疗。正如预期的那样，两种药物均显示出显著的临床疗效，并且在该组的一个子样本中，早期的研究结果得到了证实，即右旋苯丙胺而非哌醋甲酯降低了尿液及血浆中3-甲氧基-4-羟基苯乙二醇的含量以及全身去甲肾上腺素的周转率，并且两种药物均未改变尿液及血浆中高香草酸的浓度。哌醋甲酯而非右旋苯丙胺增加了血浆去甲肾上腺素的含量。两种药物均使尿液中的肾上腺素和间甲肾上腺素增加，但这种增加与临床改善并无显著相关性。
