Findling R L, Schwartz M A, Flannery D J, Manos M J
Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio 44106, USA.
J Clin Psychiatry. 1996 May;57(5):184-9.
It is becoming commonly recognized that adults suffer from attention-deficit/hyperactivity disorder (ADHD). Since medications used in the past of treat adults with ADHD may be ineffective or poorly tolerated by some patients, it is important to determine if newly available medications can safely ameliorate symptoms of ADHD in adults.
An open clinical trial was undertaken to examine whether venlafaxine was safe and effective in the treatment of adults with ADHD. Ten subjects who met DSM-IV criteria for ADHD were enrolled in this 8-week trial. Individuals were started on 37.5 mg of venlafaxine b.i.d. If moderate ADHD symptoms persisted at the end of Week 4, the dose of venlafaxine was increased to 75 mg b.i.d. Assessments of ADHD symptomatology included the ADHD Rating Scale, Self-Report Version (ARS) and the Clinical Global Impressions (CGI) scale.
Nine patients completed the study. At the end of the study, 7 patients were receiving 37.5 mg b.i.d. of venlafaxine. Repeated measures ANOVA demonstrated that treatment with venlafaxine was associated with significant reductions in ADHD symptomatology (p < .02 for the ARS; p < .005 for the CGI). Of the 9 subjects who completed the trial, 7 were considered responders. Venlafaxine was well tolerated, and most patients experienced only mild side effects.
Venlafaxine may be a promising agent for the treatment of ADHD in adults. Controlled clinical trials are needed to further examine this issue.
成人患有注意力缺陷多动障碍（ADHD）这一情况正日益得到普遍认可。由于过去用于治疗成人ADHD的药物可能对某些患者无效或耐受性差，因此确定新上市的药物能否安全改善成人ADHD症状很重要。
进行了一项开放性临床试验，以检验文拉法辛治疗成人ADHD是否安全有效。10名符合ADHD的DSM-IV标准的受试者参加了这项为期8周的试验。个体开始服用37.5mg文拉法辛，每日两次。如果在第4周结束时中度ADHD症状仍然存在，文拉法辛剂量增加至75mg，每日两次。ADHD症状学评估包括ADHD评定量表、自我报告版（ARS）和临床总体印象（CGI）量表。
9名患者完成了研究。在研究结束时，7名患者接受37.5mg文拉法辛，每日两次。重复测量方差分析表明，文拉法辛治疗与ADHD症状学显著减轻相关（ARS为p <.02；CGI为p <.005）。在完成试验的9名受试者中，7名被认为是有反应者。文拉法辛耐受性良好，大多数患者仅经历轻微副作用。
文拉法辛可能是治疗成人ADHD的一种有前景的药物。需要进行对照临床试验以进一步研究这个问题。
