Chen Yanhui, Ke Zhongling, Ouyang Ying, Han Ying, Liang Dong, Gao Xueping, He Jie, Du Yasong
Fujian Medical University Union Hospital, Fujian, China.
Sichuan Provincial People's Hospital, Sichuan, China.
Psychiatry Investig. 2024 Apr;21(4):387-395. doi: 10.30773/pi.2023.0262. Epub 2024 Apr 23.
To explore the efficacy and safety of clonidine adhesive patch in Tourette syndrome (TS) patients with comorbid attentiondeficit/hyperactivity disorder (ADHD).
This study was conducted on a sample of children and adolescents with TS who had comorbid ADHD between May 2012 and March 2015. The patients were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, and were randomly assigned to four different dose groups: 1.0 mg/week, 1.5 mg/week, 2.0 mg/week and placebo group, and the symptom was evaluated by Swanson, Nolan, and Pelham Rating Scale, Version IV (SNAP-IV) and Yale Global Tic Severity Scale scales every 2 weeks. The primary outcome was tic disorders (TD) effective rate at week 8.
One hundred and twenty-seven TS patients with comorbid ADHD in 2.0 mg/week (n=35), 1.5 mg/week (n=27), 1.0 mg/week (n=36) and placebo groups (n=29) were included in this subgroup analysis. The TD effective rate of the 2.0 mg, 1.5 mg, and 1.0 mg groups at week 8 were significantly better than that in placebo group (85.7%, 81.5%, and 86.1% vs. 20.7%, all p<0.0001). All groups demonstrated significant improvements in SNAP-IV total scale scores compared to baseline (p=0.0004), with treatment groups showing only a trend for better performance compared to placebo group at week 8, without statistical differences (22.1±15.41, 21.3±11.96, and 21.2±12.48 vs. 26.0±13.37, p=0.3385). A total of 9 adverse reactions occurred, all recovered spontaneously without additional medication.
Clonidine adhesive patch could safely and effectively reduce the tic symptoms of TS patients with comorbid ADHD, and might be potentially helpful in the ADHD symptoms control.
探讨可乐定贴片治疗合并注意缺陷多动障碍（ADHD）的抽动秽语综合征（TS）患者的疗效和安全性。
本研究选取2012年5月至2015年3月期间合并ADHD的TS儿童及青少年作为样本。患者依据《精神疾病诊断与统计手册》第四版进行诊断，并随机分为四个不同剂量组：1.0毫克/周、1.5毫克/周、2.0毫克/周及安慰剂组，每2周采用斯旺森、诺兰和佩勒姆评定量表第四版（SNAP-IV）及耶鲁综合抽动严重程度量表评估症状。主要结局指标为第8周时抽动障碍（TD）有效率。
本亚组分析纳入了2.0毫克/周组（n = 35）、1.5毫克/周组（n = 27）、1.0毫克/周组（n = 36）和安慰剂组（n = 29）共127例合并ADHD的TS患者。第8周时，2.0毫克组、1.5毫克组和1.0毫克组的TD有效率显著优于安慰剂组（85.7%、81.5%、86.1% 对比20.7%，均p < 0.0001）。与基线相比，所有组的SNAP-IV总分均有显著改善（p = 0.0004），在第8周时，治疗组与安慰剂组相比仅显示出表现更好的趋势，但无统计学差异（22.1±15.41、21.3±11.96、21.2±12.48 对比26.0±13.37，p = 0.3385）。共发生9例不良反应，均自行恢复，无需额外用药。
可乐定贴片可安全有效地减轻合并ADHD的TS患者的抽动症状，且可能有助于控制ADHD症状。
