Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial
Impairment and deportment responses to different methylphenidate doses in children with ADHD: The MTA titration trial
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DOI：
10.1097/00004583-200102000-00012
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发表时间：
2001-02-01
影响因子：
13.3
通讯作者：
Wigal, T
中科院分区：
文献类型：
--
作者：
Greenhill, LL;Swanson, JM;Wigal, T
目的：对NIMH协作性多点多模式治疗儿童注意力缺陷/多动障碍（MTA）研究的结果进行了分析，以确定双盲，安慰剂对照的哌甲酯（MPH）滴定试验是否确定了每个注意力缺陷/多动障碍（ADHD）儿童的最佳MPH剂量。方法：分配到MTA药物治疗组的ADHD儿童（n = 289）接受了一项为期28天的对照滴定方案，该方案连续几天给予不同的MPH剂量（安慰剂，低，中和高）。结果如下：重复测量方差分析显示MPH剂量的主效应对教师的损伤和行为评分的影响（F-3 = 100.6，n = 223，p =.0001;效应量0.8-1.3）大于对类似终点的父母评分的影响（F-3 = 55.81，n= 253，P =.00001，效应量0.4-0.6）。剂量与阶段、给药顺序、共病诊断、研究中心或治疗组无相互作用。结论：MTA滴定方案验证了周末MPH给药的有效性，并为体重低于25公斤的儿童确定了每日MPH总摄入量限制为35毫克。它复制了先前报道的MPH反应率（77%），受试者之间的最佳剂量（10-50 mg/天）分布，对损伤和行为的影响大小，以及剂量相关的不良事件。
Objective: Results of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) were analyzed to determine whether a double-blind, placebo-controlled methylphenidate (MPH) titration trial identified the best MPH dose for each child with attention-deficit/hyperactivity disorder (ADHD). Method: Children with ADHD assigned to MTA medication treatment groups (n = 289) underwent a controlled 28-day titration protocol that administered different MPH doses (placebo, low, middle, and high) on successive days. Results: A repeated-measures analysis of Variance revealed main effects for MPH dose with greater effects on teacher ratings of impairment and deportment (F-3 = 100.6, n = 223, p =.0001; effect sizes 0.8-1.3) than on parent ratings of similar endpoints (F-3 = 55.81, n= 253, P =.00001,effect sizes 0.4-0.6). Dose did not interact with period, dose order, comorbid diagnosis, site, or treatment group. Conclusions: The MTA titration protocol validated the efficacy of weekend MPH dosing and established a total daily lose limit of 35 mg of MPH for children weighing less than 25 kg. It replicated previously reported MPH response rates (77%), distribution of best doses (10-50 mg/day) across subjects, effect sizes on impairment and deportment, as well as dose-related adverse events.