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Use of moclobemide in children with attention deficit hyperactivity disorder
G E Trott1, H J Friese, M Menzel
1Hospital for Child and Adolescent Psychiatry, University of Würzburg, Federal Republic of Germany.
Insights
Moclobemide, a reversible inhibitor of monoamine oxidase-A, improved behavior in children with attention deficit hyperactivity disorder. This study suggests potential benefits for ADHD treatment, with good tolerability observed.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder.
- A monoamine oxidase (MAO) hypothesis for ADHD etiology has been proposed.
- Previous treatments like methylphenidate may cause side effects.
Purpose of the Study:
- To investigate the efficacy of moclobemide, a selective MAO-A inhibitor, in treating ADHD.
- To evaluate behavioral improvements and side effects in children with ADHD receiving moclobemide.
- To explore the impact of moclobemide on brain activity patterns in ADHD patients.
Main Methods:
- A 4-week study involving 12 children (ages 6-13) diagnosed with ADHD.
- Participants had previously discontinued methylphenidate due to adverse effects.
- Moclobemide was administered, with parental behavioral assessments and electroencephalography (EEG) brain mapping conducted.
Main Results:
- A 40% improvement in parental-reported behavior for outpatients and 31% for inpatients.
- Increased concentration and attention span were noted.
- Reduced frontal lobe delta activity observed via brain mapping; moclobemide was generally well-tolerated with mild gastrointestinal issues in two patients.
Conclusions:
- Moclobemide shows promise as a treatment for ADHD, particularly for children intolerant to methylphenidate.
- The drug appears to improve behavioral symptoms and cognitive functions related to attention.
- Further research is warranted to fully elucidate the therapeutic potential of MAO-A inhibition in ADHD management.
Abstract:
A monoamine oxidase hypothesis for the cause of attention deficit hyperactivity disorder has recently been established (Shekim et al. 1986). To test this, moclobemide, a new and reversible inhibitor of monoamine oxidase-A, was administered to 12 children between the ages of 6 and 13 years, diagnosed as attention deficit hyperactive according to DSM III-R, in a 4-week study. All had previously discontinued treatment with methylphenidate due to side-effects. A 40% improvement in parental assessment of children's behaviour occurred among those who received moclobemide as outpatients, and a 31% improvement among the five in-patients. There was a general increase in concentration and attention span at the end of the trial, but mood changes and explosive behaviour continued to be present at a low level. Brain mapping after moclobemide treatment showed an overall reduction in frontal lobe delta activity. Moclobemide was well tolerated by these patients, although two complained of mild gastrointestinal disturbances during the first week of therapy.