No increase in long-term risk for nicotine use disorders after treatment with methylphenidate in children with attention-deficit/hyperactivity disorder (ADHD): evidence from a non-randomised retrospective study
No increase in long-term risk for nicotine use disorders after treatment with methylphenidate in children with attention-deficit/hyperactivity disorder (ADHD): evidence from a non-randomised retrospective study
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DOI：
10.1007/s00702-008-0872-3
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发表时间：
2008-02-01
影响因子：
3.3
通讯作者：
Lehmkuhl, U.
中科院分区：
文献类型：
--
作者：
Huss, M.;Poustka, F.;Lehmkuhl, U.
Objective.评价哌甲酯（MPH）治疗ADHD儿童对尼古丁使用障碍（SUD-N）的长期影响。多中心回顾性非随机纵向研究，纳入215名ADHD儿童（9.2岁诊断; 21.9岁SUD-N重新评估），严格平行分配至MPH治疗组（n = 106）和药物初治组（n = 109）。两组之间在吸烟频率（84% MPH; 89%非MPH; chi（2）= 1.6; p = 0.21）和首次吸烟的发病年龄（对数秩1.68; p = 0.19）方面没有差异。51%（MPH）和61%（非MPH）的患者持续吸烟。生存分析显示，MPH组中持续吸烟的发病年龄有一个小的名义上显著的延迟（对数秩= 3.85; p = 0.049）。尼古丁依赖达到20%（MPH）和27%（非MPH）。两组之间的发病年龄没有差异（对数秩= 2.24; p = 0.13）。由于研究的非随机性质，MPH不会诱导SUD-N的证据有限。这些数据表明，MPH可能对ADHD患者持续尼古丁摄入延迟发作有有益作用。
Objective. To evaluate long-term effects of methylphenidate (MPH) treatment in ADHD children on the development of nicotine use disorders (SUD-N).Methods. Multisite retrospective non-randomised longitudinal study with 215 ADHD children (diagnosis at 9.2 years of age; reassessment for SUD-N at 21.9 years of age) strictly parallel allocated to MPH treated (n = 106) and drug naive (n = 109) children.Results. There was no difference between the groups with respect to frequency (84% MPH; 89% non-MPH; chi(2) = 1.6; p = 0.21) and age of onset for first cigarette smoking (log rank 1.68; p = 0.19). Continuous smoking was reached by 51% (MPH) and 61% (non-MPH) of the patients. Survival analyses revealed a small and nominally significant delay in age of onset for continuous smoking in the MPH-group (log rank = 3.85; p = 0.049). Nicotine dependency was reached by 20% (MPH) and 27% (non-MPH). Age of onset does not differ between groups (log rank = 2.24; p = 0.13).Discussion. Limited evidence due to the non-randomised nature of the study is given that MPH does not induce SUD-N. The data suggests there may be a beneficial effect of MPH on delay of onset for continuous nicotine consumption in ADHD patients.