Do typical clinical doses of methylphenidate cause tics in children treated for attention-deficit hyperactivity disorder?
Do typical clinical doses of methylphenidate cause tics in children treated for attention-deficit hyperactivity disorder?
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DOI：
10.1097/00004583-199908000-00009
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发表时间：
1999-08-01
影响因子：
13.3
通讯作者：
Schachar, RJ
中科院分区：
文献类型：
--
作者：
Law, SF;Schachar, RJ
目的：确定典型临床剂量的哌醋甲酯（MPH）是否会导致领带或加重先前存在的轻度至中度领带。方法：在一项为期1年的前瞻性研究中，91名患有注意缺陷多动障碍的儿童，有或没有共病关系（不包括严重关系和图雷特综合征），被随机分配接受MPH或安慰剂治疗。滴定目标剂量以平衡行为改变和副作用。家长和老师是观察员。结果：从安慰剂到MPH的交叉是常见的，因为行为反应差。一名接受MPH治疗的受试者退出;最终的MPH组有72名受试者;安慰剂组有18名。MPH的平均剂量为0.5 mg/kg，每日两次。在接受MPH治疗的无关联的受试者中，19.6%的受试者和接受安慰剂治疗的受试者中，16.7%的受试者出现了具有临床意义的关联（Fisher精确检验，p = 0.59，不显著;相对风险= 1.17，置信区间= 0.31-4.40）。在接受MPH治疗的33%的先前存在领带的受试者和接受安慰剂治疗的33%的受试者中观察到领带恶化（Fisher精确检验，p = 0.70，不显著;相对风险= 1.0，置信区间= 0.40-1.85），结论：基于典型临床滴定程序的MPH剂量在有或无既往病史的儿童中并没有产生比安慰剂显著更多的联系。（轻度至中度）关系。
Objective: To determine whether typical clinical doses of methylphenidate (MPH) cause ties or exacerbate preexisting mild to moderate ties. Method: Ninety-one children with attention-deficit hyperactivity disorder, with and without comorbid ties (excluding severe ties and Tourette's syndrome), were randomly assigned to receive MPH or a placebo in a 1-year prospective study. The target dose was titrated to balance behavior change and side effects. Parents and teachers were the observers. Results: Crossover from the placebo to MPH was common because of poor behavioral response. One MPH-treated subject dropped out; the final MPH group had 72 subjects; the placebo group, 18. The average dose of MPH was 0.5 mg/kg twice daily. Clinically significant ties developed in 19.6% of the subjects without preexisting ties receiving MPH and in 16.7% of those receiving the placebo (Fisher exact test, p =.59, not significant; relative risk = 1.17, confidence interval = 0.31-4.40). Deterioration of ties was observed in 33% of subjects with preexisting ties receiving MPH and in 33% of those receiving the placebo (Fisher exact test, p =.70, not significant; relative risk = 1.0, confidence interval = 0.40-1.85), Conclusions: Doses of MPH based on the typical clinical titration procedure did not produce significantly more ties than the placebo in children with or without preexisting (mild to moderate) ties.