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维洛沙嗪,一种非刺激性去甲肾上腺素再摄取抑制剂,用于治疗注意力缺陷多动障碍:三年更新

Viloxazine, a Non-stimulant Norepinephrine Reuptake Inhibitor, for the Treatment of Attention Deficit Hyperactivity Disorder: A 3 Year Update.

作者信息

Haddad Hannah W, Hankey Paul B, Ko Jimin, Eswani Zahaan, Bhatti Pravjit, Edinoff Amber N, Kaye Adam M, Kaye Alan D

机构信息

Kansas City University.

Georgetown University.

出版信息

Health Psychol Res. 2022 Jul 28;10(3):37018. doi: 10.52965/001c.37018. eCollection 2022.

Abstract

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. Current treatment options for ADHD include pharmacological treatment (stimulants, non-stimulants, anti-depressants, anti-psychotics), psychological treatment (behavioral therapy with or without parent training, cognitive training, neurofeedback), and complementary and alternative therapies (vitamin supplementation, exercise). Central nervous system (CNS) stimulants are the primary pharmacological therapy used in treatment; however, these stimulant drugs carry a high potential for abuse and severe psychological/physical dependence. Viloxazine, a non-stimulant medication without evidence of drug dependence, is a selective norepinephrine reuptake inhibitor that has historically been prescribed as an anti-depressant medication. The extended-release (ER) form was approved by the US Food and Drug Administration (FDA) in April 2021 for the treatment of ADHD in pediatric patients aged 6-17 years. Phase 2 and 3 randomized control trials have demonstrated significant efficacy of viloxazine in improving ADHD symptoms versus placebo. Related to its long-standing use as an antidepressant, the safety profile and pharmacokinetics of viloxazine are well understood. Viloxazine appears to be a suitable alternative to current standard-of-care pharmacotherapy for ADHD, but the further investigation remains to be done in comparing its efficacy to that of current treatments.

摘要

注意缺陷多动障碍(ADHD)是儿童期最常见的神经发育障碍。目前ADHD的治疗选择包括药物治疗(兴奋剂、非兴奋剂、抗抑郁药、抗精神病药)、心理治疗(有或无家长培训的行为疗法、认知训练、神经反馈)以及补充和替代疗法(维生素补充、运动)。中枢神经系统(CNS)兴奋剂是治疗中使用的主要药物疗法;然而,这些兴奋剂药物具有很高的滥用可能性和严重的心理/身体依赖性。维洛沙嗪是一种无药物依赖证据的非兴奋剂药物,是一种选择性去甲肾上腺素再摄取抑制剂,历史上一直被用作抗抑郁药物。其缓释(ER)剂型于2021年4月获得美国食品药品监督管理局(FDA)批准,用于治疗6至17岁儿科患者的ADHD。2期和3期随机对照试验已证明维洛沙嗪相对于安慰剂在改善ADHD症状方面具有显著疗效。鉴于其长期作为抗抑郁药使用,维洛沙嗪的安全性和药代动力学已得到充分了解。维洛沙嗪似乎是ADHD当前标准护理药物疗法的合适替代方案,但在将其疗效与当前治疗方法进行比较方面仍有待进一步研究。

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