An Update on Central Nervous System Stimulant Formulations in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder
An Update on Central Nervous System Stimulant Formulations in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder
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DOI：
10.1345/aph.1l523
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发表时间：
2009-06-01
影响因子：
2.9
通讯作者：
Bogart, Gregory T.
中科院分区：
文献类型：
--
作者：
Chavez, Benjamin;Sopko, Michael A., Jr.;Bogart, Gregory T.
目的：回顾关于不同兴奋剂制剂对注意力缺陷/多动障碍（ADHD）儿童和青少年的功效和安全性的最新文献，并描述许多可用剂型的优点和缺点。 数据来源：通过 PubMed/MEDLINE（2005 年至 2008 年 12 月）使用术语哌醋甲酯、安非他明、中枢神经系统兴奋剂和神经系统兴奋剂进行文献检索。注意力缺陷/多动症。此外，还对已确定的出版物中的参考引文进行了审查，并联系药品制造商以获取任何可能的其他参考资料。 研究选择和数据提取：使用上述搜索标准发现的双盲临床试验均纳入审查。如果在审查的时间段内没有针对该配方发表双盲试验，则纳入开放标签研究和 2005 年之前的研究。 数据综合：此处审查的文献证明了兴奋剂药物对患有 ADHD 的儿童和青少年的有效性和安全性。然而，兴奋剂有 19 种不同的剂型，导致这些药物的处方和配药过程中出现混乱和错误。了解和理解不同配方的优点和缺点可以实现个体化治疗。 Concerta、Focalin-XR、Adderall-XR 和 Vyvanse 等配方提供每日一次给药的便利。其中每种物质在一天中的不同时间提供不同量的兴奋剂。 Vyvanse 拥有独特的给药系统，可以降低患者滥用药物的风险。 Daytrana 使患者能够选择何时移除贴片，从而更好地控制剂量。对于无法吞咽药片的儿童来说，这也是一种可行的替代方案。对于无法吞咽片剂或胶囊的患者，可以打开 Focalin-XR、Adderall-XR、Metadate-CD 和 Ritalin-LA 的胶囊，撒在苹果酱上。结论：兴奋剂是治疗 ADHD 症状的有效药物。多种可用剂型允许个体化治疗。
OBJECTIVE: To review recent literature on the different stimulant preparations regarding efficacy and safety in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and describe advantages and disadvantages of the many available dosage formulations.DATA SOURCES: Literature retrieval was performed through PubMed/MEDLINE (2005-December 2008) using the terms methylphenidate, amphetamines, central nervous system stimulants, and attention-deficit/hyperactivity disorder. In addition, reference citations from publications identified were reviewed and drug manufacturers were contacted for any possible additional references.STUDY SELECTION AND DATA EXTRACTION: Double-blind clinical trials found using the search criteria listed above were included for review. Open-label studies and studies prior to 2005 were included if no double-blind trials were published for that formulation within the time period reviewed.DATA SYNTHESIS: The literature reviewed here demonstrates the efficacy and safety of stimulant medications in children and adolescents with ADHD. However, there are 19 different formulations of stimulants, leading to confusion and errors in prescribing and dispensing of these drugs. Knowing and understanding the advantages and disadvantages of the different formulations can lead to individualized treatment. Formulations like Concerta, Focalin-XR, Adderall-XR, and Vyvanse provide the convenience of once-daily dosing. Each of these provides varying amount of stimulants at different times of the day. Vyvanse has a unique delivery system that may lower the risk of patients abusing their medication. Daytrana gives patients more control over their dosing by being able to choose when the patch is removed; it is also a feasible alternative for children who cannot swallow pills. For patients who cannot swallow tablets or capsules, the capsules of Focalin-XR, Adderall-XR, Metadate-CD, and Ritalin-LA can be opened and sprinkled on applesauce.CONCLUSIONS: Stimulants are effective medications to treat the symptoms of ADHD. The multiple available dosage forms allow for individualization of treatment.