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赖氨酸安非他命甲硫酸盐治疗注意缺陷多动障碍儿童和青少年的综述。

Review of lisdexamfetamine dimesylate in children and adolescents with attention deficit/hyperactivity disorder.

机构信息

Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY, USA.

Departments of Pharmacy and Psychiatry, Mount Sinai West Hospital Center, New York, NY, USA.

出版信息

Curr Med Res Opin. 2020 Oct;36(10):1717-1735. doi: 10.1080/03007995.2020.1815002. Epub 2020 Sep 11.

Abstract

OBJECTIVE

Lisdexamfetamine dimesylate is a stimulant prodrug with low abuse and diversion potential that is used in treatment of attention deficit hyperactivity disorder (ADHD) in children, adolescents and adults. This current literature review article aims to examine safety and efficacy of LDX in children and adolescents for the treatment of ADHD based on currently available data.

METHODS

Relevant English language articles were identified through computerized searches of the MEDLINE database (PubMed and EMBASE) and clinical trials registry up to January 2020 using the following search terms: lisdexamfetamine dimesylate, pro-drug stimulant, attention-deficit and hyperactivity disorders, ADHD, safety, efficacy, children, adolescents, Vyvanse. Forty-two articles were reviewed, 34 of which were included into this review, selected by the limit "clinical trials". This article represents the pharmacological profile, efficacy and safety data of LDX for the treatment of ADHD in children and adolescents.

RESULTS

The collection of studies reviewed identified that LDX was both safe and efficacious in the treatment of ADHD. The most commonly exhibited side effects were appetite suppression, weight loss, headache and insomnia. In comparison to placebo, LDX significantly improved ADHD symptoms and overall quality of life in children and adolescents. In comparison to atomoxetine, LDX showed statistically significant improvements in inattention, impulsivity, and activities of daily living. In comparison to OROS-MPH and placebo, LDX and OROS-MPH showed improvements with the CGI-I score, and ADHD-RS-IV, however, LDX was superior.

CONCLUSION

Patients have seen statistically significant improvements in their ADHD symptomatology in the classroom environment, health related quality of life, and their overall behavior in comparison to placebo, atomoxetine, and OROS-MPH. However, clinical judgment should be utilized when prescribing LDX due to patient specific needs and the side effect profile.

摘要

目的

赖氨酸安非他命甲硫酸盐是一种滥用和滥用潜力低的兴奋剂前药,用于治疗儿童、青少年和成人的注意力缺陷多动障碍(ADHD)。本综述文章旨在根据现有数据评估 LDX 在儿童和青少年中治疗 ADHD 的安全性和疗效。

方法

通过计算机检索 MEDLINE 数据库(PubMed 和 EMBASE)和临床试验注册数据库,检索截至 2020 年 1 月的相关英文文献,使用以下检索词:赖氨酸安非他命甲硫酸盐、前药兴奋剂、注意力缺陷多动障碍、ADHD、安全性、疗效、儿童、青少年、Vyvanse。共检索到 42 篇文章,其中 34 篇文章通过“临床试验”的限制条件被纳入本综述,本文代表了 LDX 治疗儿童和青少年 ADHD 的药理学特征、疗效和安全性数据。

结果

所综述的研究发现,LDX 治疗 ADHD 既安全又有效。最常见的不良反应是食欲抑制、体重减轻、头痛和失眠。与安慰剂相比,LDX 显著改善了儿童和青少年的 ADHD 症状和整体生活质量。与阿托莫西汀相比,LDX 在注意力不集中、冲动和日常生活活动方面有统计学意义的改善。与 OROS-MPH 和安慰剂相比,LDX 和 OROS-MPH 均能改善 CGI-I 评分和 ADHD-RS-IV,但 LDX 更优。

结论

与安慰剂、阿托莫西汀和 OROS-MPH 相比,患者在课堂环境中的 ADHD 症状、健康相关生活质量和整体行为方面均有统计学意义的改善。然而,由于患者的具体需求和副作用谱,在开 LDX 处方时应进行临床判断。

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