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.
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.
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。
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