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替哌啶作为辅助治疗儿童注意缺陷/多动障碍的疗效和安全性:随机、双盲、安慰剂对照临床试验。

Efficacy and safety of tipepidine as adjunctive therapy in children with attention-deficit/hyperactivity disorder: Randomized, double-blind, placebo-controlled clinical trial.

机构信息

Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Psychiatry Clin Neurosci. 2019 Nov;73(11):690-696. doi: 10.1111/pcn.12913. Epub 2019 Aug 3.

Abstract

AIM

This study evaluated the efficacy and safety of tipepidine as an add-on to methylphenidate in the drug treatment of attention-deficit/hyperactivity disorder (ADHD).

METHODS

This study was an 8-week, randomized, parallel group, double-blind, placebo-controlled trial recruiting 53 ADHD-diagnosed children. Patients were randomly divided to receive methylphenidate + tipepidine or methylphenidate + placebo for 8 weeks. Participants were assessed using the parent version of ADHD Rating Scale-IV and the Clinical Global Impression scale at baseline, at week 4, and at the end of the trial. Moreover, the safety and tolerability of the treatment strategies were compared.

RESULTS

On general linear model repeated measures analysis a significant effect was seen for time × treatment interaction on the total and hyperactivity-impulsivity subscales of the Parent ADHD Rating Scale-IV during the trial period (Greenhouse-Geisser corrected: F = 3.45, d.f. = 1.52, P = 0.049, and F = 5.17, d.f. = 1.52, P = 0.014, respectively). The effect for time × treatment interaction, however, was not significant on Clinical Global Impression-Severity scale (Greenhouse-Geisser corrected: F = 1.79, d.f. = 1.43, P = 0.182). The frequencies of adverse events were similar between the two groups.

CONCLUSION

Eight weeks of treatment with tipepidine, as a supplementary medication, resulted in satisfactory efficacy and safety of the adjuvant therapy in management of patients with ADHD. Rigorous investigations, however, involving larger sample sizes, more extended treatment periods, and dose responses should be considered.

摘要

目的

本研究评估了替匹啶作为增效剂与哌甲酯联合治疗注意缺陷多动障碍(ADHD)的疗效和安全性。

方法

这是一项为期 8 周的随机、平行分组、双盲、安慰剂对照试验,共纳入 53 例 ADHD 患儿。患者被随机分为哌甲酯+替匹啶组或哌甲酯+安慰剂组,共治疗 8 周。在基线、第 4 周和试验结束时,分别采用 ADHD 评定量表-IV 父母版和临床总体印象量表对参与者进行评估。此外,比较了治疗策略的安全性和耐受性。

结果

在一般线性模型重复测量分析中,在整个试验期间,时间与治疗的交互作用对 ADHD 评定量表-IV 的总分和多动冲动分量表具有显著影响(经 Greenhouse-Geisser 校正:F = 3.45,自由度 = 1.52,P = 0.049,和 F = 5.17,自由度 = 1.52,P = 0.014)。然而,时间与治疗的交互作用对临床总体印象严重程度量表无显著影响(经 Greenhouse-Geisser 校正:F = 1.79,自由度 = 1.43,P = 0.182)。两组不良反应发生率相似。

结论

替匹啶作为辅助药物治疗 8 周,对 ADHD 患者的辅助治疗具有良好的疗效和安全性。然而,应考虑进行更严格的研究,包括更大的样本量、更长的治疗时间和剂量反应。

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