Gayleard Jessica L, Mychailyszyn Matthew P
Department of Psychology, Towson University, 8000 York Road, Towson, MD, 21252, USA.
Division of Psychology and Neuropsychology, Mt. Washington Pediatric Hospital, Baltimore, MD, USA.
Atten Defic Hyperact Disord. 2017 Sep;9(3):149-160. doi: 10.1007/s12402-017-0216-y. Epub 2017 Jan 21.
Attention-Deficit/Hyperactivity Disorder (ADHD) impacts a significant number of children and adolescents and often leads to deleterious functional impairment. Psychostimulant medication has historically been the first line of pharmacological intervention, though recent years have seen greater attention paid to non-stimulant alternatives. The objective of the present study was to conduct the most comprehensive meta-analysis to date evaluating the efficacy of atomoxetine in reducing core symptomatology of ADHD according to parent report. Selection criteria were applied, and studies were located by searching electronic databases, review of reference sections, and contact with expert researchers; article searching began on 10/01/2013, and the final search was conducted on 09/01/2014. A total of 42 studies met inclusion criteria-33 with control groups and 9 without-for a total sample of 8398 individuals. For those receiving atomoxetine, the summary pre-post (e.g., standardized mean gain) effect size estimate was 1.37 (95% CI [1.24, 1.51], p < .001); atomoxetine was found to statistically significantly outperform control conditions overall (Z = 4.07, p < .001), though results differed by the type of control group; for instance, when comparing atomoxetine to alternative medications as controls, significant differences were no longer present. The non-stimulant atomoxetine led to significant improvement in core ADHD symptomatology and should be considered as a viable pharmacological treatment option for ADHD.
注意力缺陷多动障碍（ADHD）影响着大量儿童和青少年，常常导致有害的功能损害。从历史上看，精神振奋药物一直是药物干预的一线选择，不过近年来，非兴奋剂替代药物受到了更多关注。本研究的目的是进行迄今为止最全面的荟萃分析，根据家长报告评估托莫西汀在减轻ADHD核心症状方面的疗效。我们应用了选择标准，通过搜索电子数据库、查阅参考文献以及与专家研究人员联系来查找研究；文献搜索始于2013年1月10日，最后一次搜索于2014年1月9日进行。共有42项研究符合纳入标准，其中33项有对照组，9项没有对照组，总样本量为8398人。对于接受托莫西汀治疗的患者，前后汇总效应量估计值（例如标准化平均增益）为1.37（95%置信区间[1.24, 1.51]，p <.001）；总体而言，托莫西汀在统计学上显著优于对照条件（Z = 4.07，p <.001），不过结果因对照组类型而异；例如，当将托莫西汀与替代药物作为对照进行比较时，不再存在显著差异。非兴奋剂托莫西汀能显著改善ADHD的核心症状，应被视为ADHD一种可行的药物治疗选择。
