Clemow David B
Postgrad Med. 2014 Sep;126(5):196-8. doi: 10.3810/pgm.2014.09.2814.
To raise awareness, this article provides a commentary on the frequent underdosing of atomoxetine for the treatment of adult attention-deficit/hyperactivity disorder (ADHD) that may be associated with poor patient outcomes. Data suggest an adequate atomoxetine dose for sufficient duration is important for ADHD symptom improvement. Despite the recommended 80 mg/day target dose, real-world data show that an approximately 60 mg/day average adult atomoxetine dose is utilized. This article discusses the factors that may contribute to this suboptimal dosing. Atomoxetine dose titration, setting patient expectations, and the importance of keeping the patient at target dose for an adequate length of time (about 4−6 weeks) prior to judging efficacy are also discussed.
为提高认识,本文对成人注意力缺陷多动障碍(ADHD)治疗中托莫西汀用药不足的常见情况进行评论,这种不足可能与患者预后不良有关。数据表明,足够疗程的充足托莫西汀剂量对改善ADHD症状很重要。尽管推荐的目标剂量为80毫克/天,但实际数据显示,成人托莫西汀的平均剂量约为60毫克/天。本文讨论了可能导致这种剂量未达最佳水平的因素。还讨论了托莫西汀的剂量滴定、设定患者预期以及在判断疗效之前让患者维持目标剂量足够长的时间(约4 - 6周)的重要性。