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注意力缺陷多动障碍青少年的多巴胺转运体基因型与兴奋剂剂量反应

Dopamine transporter genotype and stimulant dose-response in youth with attention-deficit/hyperactivity disorder.

作者信息

Stein Mark A, Waldman Irwin, Newcorn Jeffrey, Bishop Jeffrey, Kittles Rick, Cook Edwin H

机构信息

1 Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, and University of Washington , Seattle, Washington.

出版信息

J Child Adolesc Psychopharmacol. 2014 Jun;24(5):238-44. doi: 10.1089/cap.2013.0102. Epub 2014 May 9.

Abstract

OBJECTIVES

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).

METHODS

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.

RESULTS

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.

CONCLUSIONS

ADHD youth with the 9/9 genotype may require higher stimulant doses to achieve adequate symptom control.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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