Long-term methylphenidate therapy in children with comorbid attention-deficit hyperactivity disorder and chronic multiple tic disorder
Long-term methylphenidate therapy in children with comorbid attention-deficit hyperactivity disorder and chronic multiple tic disorder
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DOI：
10.1001/archpsyc.56.4.330
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发表时间：
1999-04-01
影响因子：
--
通讯作者：
Grossman, S
中科院分区：
文献类型：
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作者：
Gadow, KD;Sverd, J;Grossman, S
工作背景：本研究探讨了注意缺陷多动（ADHD）的行为和运动和声音的关系，在长期治疗哌甲酯。方法：34个青春期前儿童多动症和慢性多发性抽动障碍（谁参加了8周。双盲、安慰剂对照哌醋甲酯评价）以6个月的间隔评价2年，作为前瞻性、非盲、随访研究的一部分。通过在模拟（基于诊所）教室中直接观察儿童行为以及由父母和医生完成的行为评定量表来评估治疗效果。录像带的模拟教室进行了评分的编码器谁是盲目的治疗status.Results：有没有证据（组数据），运动领带或声乐领带改变的频率或严重程度在维持治疗期间相比，诊断或初始双盲安慰剂评价，急性药物试验期间表现出的行为改善，在随访期间保持。有没有证据（组数据）的临床显着不良药物对心血管功能或生长的影响，在结束2 years of treatment.Conclusions：哌甲酯的长期治疗似乎是安全和有效的ADHD行为的管理在许多（但不一定是所有）轻度至中度抽动障碍的儿童。尽管如此，仔细的临床监测是强制性的，以排除个别患者药物诱导的抽动加重的可能性。
Background: This study examined changes in attention-deficit hyperactivity (ADHD) behaviors and mo tor and vocal ties during long-term treatment with methylphenidate.Methods: Thirty-four prepubertal children with ADHD and chronic multiple tic disorder (who had participated in an 8-week. double-blind, placebo-controlled methylphenidate evaluation) were evaluated at 6-month intervals for 2 years as part of a prospective, nonblind, follow-up study. Treatment effects were assessed using direct observations of child behavior in a simulated (clinic-based) classroom and behavior rating scales completed by parents and physician. Video tapes of the simulated classroom were scored by coders who were blind to treatment status.Results: There was no evidence (group data) that motor ties or vocal ties changed in frequency or severity during maintenance therapy compared with diagnostic or initial double-blind placebo evaluations, Behavioral improvements demonstrated during the acute drug trial were maintained during follow-up. There was no evidence (group data) of clinically significant adverse drug effects on cardiovascular function or growth at the end of 2 years of treatment.Conclusions: Long-term treatment with methylphenidate seems to be safe and effective for the management of ADHD behaviors in many (but not necessarily all) children with mild to moderate tic disorder. Nevertheless, careful clinical monitoring is mandatory to rule out the possibility of drug-induced tic exacerbation in individual patients.