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用于治疗注意力缺陷多动障碍的哌甲酯的药代动力学评估。

An evaluation of the pharmacokinetics of methylphenidate for the treatment of attention-deficit/ hyperactivity disorder.

作者信息

Frölich Jan, Banaschewski Tobias, Döpfner Manfred, Görtz-Dorten Anja

机构信息

Central Institute of Mental Health, Child and Adolescent Psychiatry Clinic , Postbox: 12 21 20, 68072 Mannheim , Germany +49 711 2845928 ; +49 711 2845929 ;

出版信息

Expert Opin Drug Metab Toxicol. 2014 Aug;10(8):1169-83. doi: 10.1517/17425255.2014.922542. Epub 2014 May 26.

Abstract

INTRODUCTION

Methylphenidate (MPH) plays a principal role in the multimodal treatment of attention-deficit/hyperactivity disorder (ADHD). Controlled studies have demonstrated an effective reduction in the core symptoms of the disorder following MPH therapy, although long-term studies also demonstrate that the therapeutic benefits dissipate in the absence of combined psychosocial interventions.

AREAS COVERED

This review article focuses on the pharmacological characteristics of MPH, examining its effects on brain metabolism and the neurotransmitter system. Neuropsychological and clinical effects of different immediate and extended release MPH formulations are discussed to aid clinicians in choosing the appropriate formulation. The drug's addictive potency and abuse potential is also discussed. Data came from a literature search of relevant studies performed using the PubMed database up to June 2013.

EXPERT OPINION

MPH is effective in the treatment of the core symptoms of ADHD. Considerable clinical expertise is required to identify an individually well-adapted dosage which will produce the optimal clinical effects with potential side effects minimized. Due to low adherence to medication, especially in adolescents, motivation to treatment and attentive clinical monitoring is mandatory, as is the consideration of risks of abuse or the presence of a comorbid addictive disorder.

摘要

引言

哌甲酯(MPH)在注意缺陷多动障碍(ADHD)的多模式治疗中发挥着主要作用。对照研究表明,MPH治疗后该疾病的核心症状能有效减轻,不过长期研究也表明,在没有联合心理社会干预的情况下,治疗效果会逐渐消失。

涵盖领域

这篇综述文章聚焦于MPH的药理学特性,研究其对脑代谢和神经递质系统的影响。讨论了不同速释和缓释MPH制剂的神经心理学和临床效果,以帮助临床医生选择合适的制剂。还讨论了该药物的成瘾性和滥用可能性。数据来自截至2013年6月使用PubMed数据库进行的相关研究的文献检索。

专家观点

MPH对治疗ADHD的核心症状有效。需要相当多的临床专业知识来确定个体适应性良好的剂量,以产生最佳临床效果并将潜在副作用降至最低。由于服药依从性低,尤其是在青少年中,治疗动机和密切的临床监测必不可少,同时还需考虑滥用风险或是否存在共病成瘾性障碍。

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