Stein Mark A, Waldman Irwin, Newcorn Jeffrey, Bishop Jeffrey, Kittles Rick, Cook Edwin H
1 Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, and University of Washington , Seattle, Washington.
J Child Adolesc Psychopharmacol. 2014 Jun;24(5):238-44. doi: 10.1089/cap.2013.0102. Epub 2014 May 9.
This study seeks to determine if variation in the dopamine transporter gene (SLC6A3/DAT1) moderates the dose-response effects of long-acting dexmethylphenidate (D-MPH) and mixed amphetamine salts (MAS) in children with attention-deficit/hyperactivity disorder (ADHD).
Fifty-six children and adolescents (mean age=11.7±2.2) participated in a double-blind, two period crossover, dose-response study with a randomized placebo week in each 4 week drug period. Each period consisted of sequential week-long exposures to three dose levels (10, 20, 25-30 mg, depending upon weight) of D-MPH or MAS.
Doses of 10-20 mg of either D-MPH or MAS had little to no effect on hyperactivity-impulsivity and total ADHD symptom scores in subjects with the 9/9 genotype; this was in contrast to the dose-response curves of subjects with either the 10/10 or 10/9 genotype.
ADHD youth with the 9/9 genotype may require higher stimulant doses to achieve adequate symptom control.
本研究旨在确定多巴胺转运体基因(SLC6A3/DAT1)的变异是否会调节长效右苯丙胺(D-MPH)和苯丙胺混合盐(MAS)对注意力缺陷多动障碍(ADHD)儿童的剂量反应效应。
56名儿童和青少年(平均年龄 = 11.7±2.2)参与了一项双盲、两阶段交叉的剂量反应研究,在每个为期4周的药物治疗阶段都有一个随机的安慰剂周。每个阶段包括连续一周接触三种剂量水平(根据体重分别为10、20、25 - 30毫克)的D-MPH或MAS。
对于9/9基因型的受试者,10 - 20毫克的D-MPH或MAS剂量对多动冲动及ADHD总症状评分几乎没有影响;这与10/10或10/9基因型受试者的剂量反应曲线形成对比。
9/9基因型的ADHD青少年可能需要更高剂量的兴奋剂才能实现足够的症状控制。