Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
J Adolesc Health. 2012 Dec;51(6):601-7. doi: 10.1016/j.jadohealth.2012.03.005. Epub 2012 Apr 20.
Young adults with ADHD have been shown to be at increased risk for impairment in driving behaviors. Although stimulant medications have proven efficacy in reducing ADHD symptomatology, there is limited knowledge as to their effects on driving behavior. The focus of this report is on assessing the impact of lisdexamfetamine dimesylate (LDX) on driving behaviors in young adults with ADHD using a validated driving behavior questionnaire.
This assessment was carried out in the context of a randomized, double-blind, 6-week, placebo-controlled, parallel-design study of LDX versus placebo. Subjects were 61 outpatients of both sexes, 18-26 years of age, who met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for ADHD. Subjects were randomized to receive LDX or placebo for 6 weeks. Driving behavior was assessed at baseline and at the end of treatment using a U.S. version of the Manchester Driving Behavior Questionnaire (DBQ).
Highly significant improvements were documented on LDX, over placebo, in driving behaviors assessed through the DBQ in measures of driving errors, driving lapses, and a trend toward fewer driving violations. There were no meaningful associations between these DBQ results and previously documented changes in a laboratory driving simulation paradigm or with improvement in symptoms of ADHD assessed through the ADHD rating scale.
LDX treatment was associated with significant improvements in self-reported driving behaviors that were independent of improvement in symptoms of ADHD. These results suggest that LDX may reduce behaviors associated with driving risks in young adults with ADHD.
已有研究表明,患有注意缺陷多动障碍(ADHD)的年轻人在驾驶行为方面存在受损的风险增加。虽然兴奋剂药物已被证明可有效减轻 ADHD 症状,但关于它们对驾驶行为的影响的知识有限。本报告的重点是使用经过验证的驾驶行为问卷评估右苯丙胺(LDX)对患有 ADHD 的年轻成年人驾驶行为的影响。
这一评估是在一项为期 6 周、随机、双盲、安慰剂对照、平行设计的 LDX 与安慰剂的研究背景下进行的。研究对象为 61 名年龄在 18-26 岁的男女门诊患者,他们符合《精神障碍诊断与统计手册》第四版 ADHD 的诊断标准。患者被随机分为 LDX 组或安慰剂组,接受 6 周的治疗。使用美国版曼彻斯特驾驶行为问卷(DBQ)在基线和治疗结束时评估驾驶行为。
在驾驶行为方面,LDX 组在 DBQ 的多项评估指标中,包括驾驶失误、驾驶疏忽以及驾驶违规行为的趋势方面,均较安慰剂组有显著改善。这些 DBQ 结果与之前记录的实验室驾驶模拟范式中的变化或 ADHD 评分量表中 ADHD 症状改善之间没有明显的关联。
LDX 治疗与自我报告的驾驶行为的显著改善相关,这些改善与 ADHD 症状的改善无关。这些结果表明,LDX 可能会降低患有 ADHD 的年轻成年人与驾驶风险相关的行为。