长期治疗ADHD的药物 (LMA) 试验:对儿童和青少年进行为期2年的前性观察性研究. 核心症状,日常功能和并发症结果
M Johnson1, J Åsberg Johnels2, S Östlund2
1Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. mats.johnson@gnc.gu.se.
European archives of psychiatry and clinical neuroscience
|January 27, 2024
概括
这项为期2年的试验发现,长期使用ADHD药物显著改善了ADHD症状和复杂伴随疾病的儿童和青少年的日常功能. 大多数副作用是轻微的,并伴随症状也显示改善.
科学领域:
- 儿科精神病学 儿科精神病学
- 神经发育障碍 神经发育障碍
- 药理疗法 药理疗法 药理疗法
背景情况:
- 儿童和青少年注意力缺陷多动症 (ADHD) 药物治疗的长期结果,特别是那些患有复杂并发症的儿童和青少年,需要进一步调查.
- 现有的研究往往缺乏延长的随访期,以评估持续的疗效和耐受性.
研究的目的:
- 评估个别定制的ADHD药物对儿童和青少年症状严重程度,日常功能,并发症和耐受性的长期 (2年) 影响.
- 在复杂的儿科群体中扩大对ADHD治疗的理解.
主要方法:
- 一项前性观察性2年试验 (ADHD长期药物治疗 - LMA) 涉及儿童和青少年 (6-18岁) 被诊断为DSM-5ADHD和复杂的并发症.
- 药物管理是个性化的,定期间隔 (1-24个月) 进行后续评估,使用标准化尺度,如CGI-S,CGI-I,ADHD-RS和WFIRS-P.
- 系统监测不良事件 (AEs) 和并发症症状.
主要成果:
- 在2年内,在ADHD症状严重度 (CGI-S ES=2.28,ADHD-RS ES=2.06) 和日常功能中适度到大程度的改善 (WFIRS-P总ES=0.73) 中观察到显著和大的改善.
- 伴随性疾病症状,特别是对立症状,抑郁和焦虑,在1年后出现改善.
- 停药率为23%,主要原因包括不良事件,搬迁或不再需要药物. 主要的副作用包括食欲不佳,情绪低落,焦虑,易怒和疲劳.
结论:
- 长期的ADHD药物治疗为患有复杂并发症的儿科患者的ADHD症状和日常功能提供了强大而持续的好处.
- 治疗一般耐受良好,大多数不良事件是轻微的.
- 伴随性疾病的改善表明,多动症治疗对同时出现的挑战有积极的影响.
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