Sverd J, Gadow K D, Paolicelli L M
J Am Acad Child Adolesc Psychiatry. 1989 Jul;28(4):574-9; discussion 580-2. doi: 10.1097/00004583-198907000-00016.
The effects of methylphenidate on four boys diagnosed as attention-deficit hyperactivity disorder (ADHD) and Tourette's syndrome (TS) were examined under single-blind, placebo-controlled conditions. Clinical ratings and playroom observations showed improvement in ADHD symptoms with methylphenidate. Results also indicated that methylphenidate had no untoward effects on the frequency of tic occurrence. In all four children, the highest dose resulted in improved classroom ratings of tics compared with initial placebo treatment. In three cases, mild tic exacerbation was reported for a lower dose. Because variability of tic status was observed in the experimental conditions, the findings suggest the possibility that tic response was independent of clinical doses of methylphenidate. The findings were also consistent with the theory that methylphenidate, a dopamine agonist, might effect tic status by altering dopamine receptor sensitivity. Further investigation of these effects is indicated, given the efficacy of methylphenidate in treating ADHD symptoms of TS patients.
在单盲、安慰剂对照条件下，研究了哌甲酯对四名被诊断为注意力缺陷多动障碍（ADHD）和抽动秽语综合征（TS）男孩的影响。临床评分和游戏室观察显示，哌甲酯可改善ADHD症状。结果还表明，哌甲酯对抽动发生频率没有不良影响。在所有四名儿童中，与最初的安慰剂治疗相比，最高剂量导致课堂上抽动评分改善。在三个案例中，较低剂量报告有轻度抽动加重。由于在实验条件下观察到抽动状态的变异性，研究结果提示抽动反应可能与哌甲酯的临床剂量无关。这些发现也与多巴胺激动剂哌甲酯可能通过改变多巴胺受体敏感性来影响抽动状态的理论一致。鉴于哌甲酯在治疗TS患者ADHD症状方面的疗效，表明需要对这些影响进行进一步研究。
