兴奋剂对学前注意力缺陷/多动障碍的有效性:系统性审查和元分析
Luisa S Sugaya1,2, Luis C Farhat1,2, Pietro Califano1
1Department of Psychiatry Faculdade de Medicina FMUSP Universidade de São Paulo São Paulo Brazil.
兴奋剂有效地减少了学龄前儿童注意力缺陷/多动症 (ADHD) 症状. 这一系统性审查支持考虑使用兴奋剂药物治疗幼儿多动症.
科学领域:
- 儿科神经学 儿科神经学
- 心理药理学 心理药理学
- 基于证据的医学基于证据的医学.
背景情况:
- 对于治疗注意力缺陷/多动障碍 (ADHD) 的学龄前儿童的有效证据有限.
- 系统性审查对于综合证据至关重要,以指导对这一群体的治疗建议.
研究的目的:
- 评估对被诊断患有ADHD的学龄前儿童的兴奋剂药物的有效性和可接受性.
- 为临床医生提供基于证据的总结,关于在患有ADHD的幼儿中使用兴奋剂.
主要方法:
- 双盲随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了主要的电子数据库和临床试验注册表,截至2022年3月/7月.
- 使用随机效应模型评估了ADHD症状严重程度 (有效性) 和全因学率 (可接受性).
主要成果:
- 包括5个RCT,涉及489名参与者.
- 与安慰剂相比,兴奋剂显著降低了ADHD症状严重程度 (SMD = -0.59,p < 0.0001).
- 在兴奋剂和安慰剂之间没有发现可接受性 (因任何原因中止) 的显著差异.
结论:
- 刺激药物在降低学龄前儿童ADHD症状方面是有效的.
- 临床医生应该考虑兴奋剂作为 ADHD 的学龄前儿童的治疗选择.
- 对疗效证据的信心中等,但对可接受性估计的信心低,需要进一步研究.
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