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Methylphenidate, Guanfacine, and Combined Treatment Effects on Electroencephalography Correlates of Spatial Working Memory in Attention-Deficit/Hyperactivity Disorder.哌甲酯、胍法辛及联合治疗对注意缺陷多动障碍患者空间工作记忆的脑电图相关性的影响。
J Am Acad Child Adolesc Psychiatry. 2023 Jan;62(1):37-47. doi: 10.1016/j.jaac.2022.06.017. Epub 2022 Aug 10.
2
Methylphenidate remediates aberrant brain network dynamics in children with attention-deficit/hyperactivity disorder: A randomized controlled trial.哌醋甲酯可纠正注意缺陷多动障碍儿童的异常脑网络动态:一项随机对照试验。
Neuroimage. 2022 Aug 15;257:119332. doi: 10.1016/j.neuroimage.2022.119332. Epub 2022 May 28.
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Causal effects of psychostimulants on neural connectivity: a mechanistic, randomized clinical trial.精神兴奋剂对神经连通性的因果效应:一项基于机制的随机临床试验。
J Child Psychol Psychiatry. 2022 Nov;63(11):1381-1391. doi: 10.1111/jcpp.13585. Epub 2022 Feb 9.
4
Effects of methylphenidate on executive functioning in children and adolescents with ADHD after long-term use: a randomized, placebo-controlled discontinuation study.长期使用哌醋甲酯对 ADHD 儿童和青少年执行功能的影响:一项随机、安慰剂对照停药研究。
J Child Psychol Psychiatry. 2021 Dec;62(12):1444-1452. doi: 10.1111/jcpp.13419. Epub 2021 Mar 28.
5
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Neurobiol Learn Mem. 2020 Dec;176:107327. doi: 10.1016/j.nlm.2020.107327. Epub 2020 Oct 17.
6
Safety and efficacy of guanfacine extended-release in adults with attention-deficit/hyperactivity disorder: an open-label, long-term, phase 3 extension study.胍法辛缓释剂在成人注意缺陷多动障碍中的安全性和疗效:一项开放标签、长期、3 期扩展研究。
BMC Psychiatry. 2020 Oct 2;20(1):485. doi: 10.1186/s12888-020-02867-8.
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Switching from Clonidine Immediate-Release to Guanfacine Extended-Release.从可乐定速释剂转换为胍法辛缓释剂。
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Clonidine as a Treatment of Behavioural Disturbances in Autism Spectrum Disorder: A Systematic Literature Review.可乐定治疗自闭症谱系障碍行为障碍的系统文献综述
J Can Acad Child Adolesc Psychiatry. 2020 May;29(2):110-120. Epub 2020 May 1.
9
Evaluation of the current data on guanfacine extended release for the treatment of ADHD in children and adolescents.评估胍法辛缓释剂治疗儿童和青少年注意缺陷多动障碍的现有数据。
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10
Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents.儿童和青少年注意缺陷多动障碍的诊断、评估和治疗临床实践指南。
Pediatrics. 2019 Oct;144(4). doi: 10.1542/peds.2019-2528.

α-2激动剂在儿童注意力缺陷多动障碍中的作用:综述

The Role of Alpha-2 Agonists for Attention Deficit Hyperactivity Disorder in Children: A Review.

作者信息

Neuchat Elisa E, Bocklud Brooke E, Kingsley Kali, Barham William T, Luther Patrick M, Ahmadzadeh Shahab, Shekoohi Sahar, Cornett Elyse M, Kaye Alan D

机构信息

School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA.

School of Medicine, Louisiana State University Health Sciences Center at New Orleans, New Orleans, LA 70112, USA.

出版信息

Neurol Int. 2023 May 22;15(2):697-707. doi: 10.3390/neurolint15020043.

DOI:10.3390/neurolint15020043
PMID:37218982
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10204383/
Abstract

INTRODUCTION

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders, characterized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is marked by symptoms such as inappropriate levels of inattention, hyperactivity, and impulsivity that can affect academic, social, and personal functioning in children and adolescents. This review summarizes clinical trials demonstrating the effectiveness of Alpha-2 agonists in reducing symptoms of inattention, hyperactivity, and impulsivity in children with ADHD. Studies were identified through a systematic search of PubMed and Cochrane databases. However, these medications' long-term safety and efficacy remain uncertain, with a lack of data on their effects on growth, cardiovascular function, and other adverse events. Further studies are required to determine these medications' optimal dose and treatment duration.

METHODS

Medications that target the noradrenergic system, such as Alpha-2 agonists, have been increasingly used as a treatment option for ADHD, with guanfacine and clonidine being two of the most commonly used medications. They function by selectively targeting Alpha-2 adrenergic receptors in the brain leading to improved attention and reduced hyperactivity and impulsivity symptoms in children with ADHD.

RESULTS

Clinical trials have demonstrated the effectiveness of Alpha-2 agonists in treating ADHD in children by reducing symptoms of inattention, hyperactivity, and impulsivity. However, these medications' long-term safety and efficacy still need to be completely understood. Due to a lack of information on the effects of Alpha-2 agonists on growth, cardiovascular function, and other long-term adverse events, more studies must investigate the optimal dose and treatment duration for these medications.

CONCLUSIONS

Despite these concerns, Alpha-2 agonists remain a valuable treatment option for ADHD in children, especially those unable to tolerate stimulant medications or who have coexisting conditions such as tic disorders. Future research should continue to explore the safety and efficacy of Alpha-2 agonists in the long term. In conclusion, Alpha-2 agonists show promise as a treatment for ADHD in children; however, the safety and efficacy of these drugs in the long term are not yet completely understood. Additional studies are required to investigate the optimal dose and treatment duration for these medications in their use as a treatment for this debilitating disease.

摘要

引言

注意缺陷多动障碍(ADHD)是最常见的神经发育障碍之一,由《精神疾病诊断与统计手册》第五版(DSM-5)定义,其特征是注意力不集中、多动和冲动程度异常,这些症状会影响儿童和青少年的学业、社交及个人功能。本综述总结了临床试验,这些试验证明了α-2激动剂在减轻ADHD儿童注意力不集中、多动和冲动症状方面的有效性。通过对PubMed和Cochrane数据库进行系统检索确定了相关研究。然而,这些药物的长期安全性和有效性仍不确定,缺乏关于它们对生长、心血管功能及其他不良事件影响的数据。需要进一步研究以确定这些药物的最佳剂量和治疗时长。

方法

靶向去甲肾上腺素能系统的药物,如α-2激动剂,已越来越多地被用作ADHD的治疗选择,胍法辛和可乐定是最常用的两种药物。它们通过选择性靶向大脑中的α-2肾上腺素能受体发挥作用,从而改善ADHD儿童的注意力并减轻多动和冲动症状。

结果

临床试验已证明α-2激动剂在治疗ADHD儿童方面的有效性,可减轻注意力不集中、多动和冲动症状。然而,这些药物的长期安全性和有效性仍有待完全了解。由于缺乏关于α-2激动剂对生长、心血管功能及其他长期不良事件影响的信息,必须开展更多研究来探究这些药物的最佳剂量和治疗时长。

结论

尽管存在这些问题,但α-2激动剂仍然是治疗儿童ADHD的宝贵选择,尤其是那些无法耐受刺激性药物或患有抽动障碍等共存疾病的儿童。未来的研究应继续探索α-2激动剂的长期安全性和有效性。总之,α-2激动剂有望成为治疗儿童ADHD的药物;然而,这些药物的长期安全性和有效性尚未完全明确。需要开展更多研究来探究这些药物作为治疗这种致残性疾病的最佳剂量和治疗时长。