Metilfenidato para el trastorno por déficit de atención/hiperactividad en niños y adolescentes
Ole J Storebø1, Erik Simonsen2, Christian Gluud3
1Psychiatric Research Unit, Child and Adolescent Psychiatric Department, Region Zealand Psychiatry, Region Zealand, Denmark.
JAMA
|May 11, 2016
Resumen
El metilfenidato puede mejorar los síntomas y el comportamiento del trastorno por déficit de atención e hiperactividad (TDAH), pero la calidad de la evidencia es baja. El medicamento está relacionado con más efectos secundarios no graves, con datos limitados sobre eventos graves.
Área de la Ciencia:
- Neurología pediátrica
- Psiquiatría infantil y adolescente
- Farmacología
Sus antecedentes:
- El trastorno por déficit de atención e hiperactividad (TDAH) es un trastorno del desarrollo neurológico común en niños y adolescentes.
- El metilfenidato es un medicamento estimulante ampliamente prescrito para el tratamiento del TDAH.
- La comprensión de los beneficios y daños del metilfenidato es crucial para la toma de decisiones clínicas.
Objetivo del estudio:
- Evaluar la asociación entre el tratamiento con metilfenidato y los resultados en el TDAH pediátrico.
- Evaluar tanto los beneficios como los daños potenciales del metilfenidato en niños y adolescentes con TDAH.
Principales métodos:
- Revisión sistemática y metanálisis de ensayos controlados aleatorios.
- La inclusión de estudios que evalúan la eficacia y la seguridad del metilfenidato en poblaciones pediátricas con TDAH.
- Evaluación de los síntomas de TDAH, comportamiento general, calidad de vida y eventos adversos.
Principales resultados:
- El metilfenidato se asocia con mejoras en los síntomas del TDAH, el comportamiento general y la calidad de vida.
- La calidad de la evidencia que respalda estas mejoras es muy baja, lo que hace que la magnitud sea incierta.
- Se observó un aumento del riesgo de eventos adversos no graves con el uso de metilfenidato.
- No existen datos suficientes para evaluar la asociación con eventos adversos graves.
Conclusiones:
- El metilfenidato muestra un beneficio potencial para los síntomas del TDAH, el comportamiento y la calidad de vida en pacientes pediátricos.
- La importancia clínica de estos beneficios es incierta debido a la evidencia de muy baja calidad.
- El metilfenidato está asociado con una mayor incidencia de reacciones adversas no graves.
- Se necesitan más investigaciones para determinar completamente el perfil de seguridad, especialmente en lo que respecta a los eventos adversos graves.
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