Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, Charlottesville, VA, USA.
J Clin Psychopharmacol. 2012 Apr;32(2):225-30. doi: 10.1097/JCP.0b013e3182496dc5.
This study investigated whether methylphenidate delivered through a long-acting transdermal system (MTS) would reduce collision rates of young adult drivers with attention-deficit/hyperactivity disorder (ADHD).Seventeen young adults completing the study (mean [SD] age, 20.82 [2.40] years; 14 men and 13 white) met the following inclusion criteria: ADHD diagnoses but not routinely taking ADHD medication, previously responsive to ADHD medication, active drivers with more than 1 collision or citation in the past 2 years, and no significant comorbidities. In this open-labeled, crossover design drivers were randomly assigned either to the no-medication condition for 3 months and then MTS for 3 months or to the reverse sequence. In-car video monitoring of routine driving occurred during these 6 months. At baseline and after each condition, participants completed the Conners Adult ADHD Rating Scale and the Cox Assessment of Risky Driving Scale, and their blood pressure, heart rate, and body weight were monitored.Compared with the no-medication condition, participants in the MTS condition self-reported fewer total ADHD (P < 0.04) and inattentive symptoms (P = 0.014) and a trend for risky driving behaviors (P = 0.059) and had fewer video-recorded collisions (P < 0.005) and other problematic driving events. There were no significant changes in blood pressure, heart rate, or body weight across conditions or any significant skin reactions to the MTS patch.This is the first study demonstrating that long-acting methylphenidate improves activities of daily living among young adults with ADHD. Specifically, methylphenidate improved safety in routine driving while reducing ADHD symptoms with minimal adverse effects.
这项研究调查了长效透皮系统(MTS)给予哌醋甲酯是否会降低患有注意缺陷多动障碍(ADHD)的年轻成年驾驶员的碰撞率。17 名完成研究的年轻成年人(平均[SD]年龄,20.82[2.40]岁;14 名男性和 13 名白人)符合以下纳入标准:ADHD 诊断但不常规服用 ADHD 药物、以前对 ADHD 药物有反应、有活跃的驾驶员,在过去 2 年内有超过 1 次碰撞或罚单,且无明显合并症。在这项开放性、交叉设计研究中,驾驶员被随机分配到无药物治疗组 3 个月,然后是 MTS 治疗组 3 个月,或相反的顺序。在这 6 个月中,对日常驾驶进行车内视频监测。在基线和每个条件后,参与者完成了 Conners 成人 ADHD 评定量表和 Cox 危险驾驶量表评估,监测他们的血压、心率和体重。与无药物治疗组相比,MTS 组参与者自我报告的总 ADHD(P < 0.04)和注意力不集中症状(P = 0.014)较少,危险驾驶行为(P = 0.059)呈趋势,视频记录的碰撞(P < 0.005)和其他有问题的驾驶事件较少。在条件之间或任何明显的皮肤对 MTS 贴片反应方面,血压、心率或体重均无显著变化。这是第一项表明长效哌醋甲酯可改善 ADHD 年轻成年人日常生活活动的研究。具体来说,哌醋甲酯在减少 ADHD 症状的同时提高了日常驾驶的安全性,且副作用最小。