Vogt Carsten, Williams Tim
Berkshire Healthcare NHS Foundation Trust, Reading CAMHS, Craven Road, Reading, RG 1 5 LF, UK. E-mail:
Child Adolesc Ment Health. 2011 Sep;16(3):144-149. doi: 10.1111/j.1475-3588.2010.00593.x. Epub 2011 Jan 17.
The aim of this study was to evaluate stimulant medication response following a single dose of methylphenidate (MPH) in children and young people with hyperkinetic disorder using infrared motion analysis combined with a continuous performance task (QbTest system) as objective measures. The hypothesis was put forward that a moderate testdose of stimulant medication could determine a robust treatment response, partial response and non-response in relation to activity, attention and impulse control measures.
The study included 44 children and young people between the ages of 7-18 years with a diagnosis of hyperkinetic disorder (F90 & F90.1). A single dose-protocol incorporated the time course effects of both immediate release MPH and extended-release MPH (Concerta XL, Equasym XL) to determine comparable peak efficacy periods post intake.
A robust treatment response with objective measures reverting to the population mean was found in 37 participants (84%). Three participants (7%) demonstrated a partial response to MPH and four participants (9%) were determined as non-responders due to deteriorating activity measures together with no improvements in attention and impulse control measures.
Objective measures provide early into prescribing the opportunity to measure treatment response and monitor adverse reactions to stimulant medication. Most treatment responders demonstrated an effective response to MPH on a moderate testdose facilitating a swift and more optimal titration process.
本研究旨在通过结合连续执行任务(QbTest系统)的红外运动分析作为客观测量方法,评估患有多动障碍的儿童和青少年单次服用哌甲酯(MPH)后的兴奋剂药物反应。提出的假设是,适度的兴奋剂药物测试剂量可以确定在活动、注意力和冲动控制测量方面的强烈治疗反应、部分反应和无反应情况。
该研究纳入了44名年龄在7至18岁之间、诊断为多动障碍(F90和F90.1)的儿童和青少年。单一剂量方案纳入了速释MPH和缓释MPH(康奈达XL、依夸西姆XL)的时间过程效应,以确定摄入后可比的峰值疗效期。
37名参与者(84%)出现了客观测量显示恢复到总体均值的强烈治疗反应。3名参与者(7%)对MPH表现出部分反应,4名参与者(9%)由于活动测量恶化且注意力和冲动控制测量无改善而被确定为无反应者。
客观测量为开处方提供了早期机会,以测量治疗反应并监测对兴奋剂药物的不良反应。大多数治疗反应者在适度测试剂量下对MPH表现出有效反应,有助于快速且更优化的滴定过程。