用于儿童和青少年注意力缺陷多动症障碍 (ADHD) 的甲基
Ole Jakob Storebø1,2,3, Maja Rosenberg Overby Storm1, Johanne Pereira Ribeiro1
1Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark.
甲基酸盐可能会改善儿童的多动症症状和行为,但证据的确定性非常低. 药物可能会增加不严重的不良事件,如睡眠问题,对严重事件和生活质量的影响尚不清楚.
科学领域:
- 精神病学和行为科学
- 儿科神经学 儿科神经学
- 临床药理学 临床药理学
背景情况:
- 注意缺陷多动障碍 (ADHD) 是一种常见的儿童精神疾病,其特点是注意力困难,多动和冲动.
- 甲基酸盐是经常用于ADHD的精神兴奋剂,但它的益处和危害需要更新的证据.
- 本系统性审查提供了对甲基胺在儿童多动症患者群体中疗效和安全性的最新评估.
研究的目的:
- 在被诊断为ADHD的儿童和青少年中全面评估甲基酸的有益和有害影响.
- 更新以前的系统性审查,并纳入最近的随机临床试验甲基胺治疗儿科多动症.
主要方法:
- 随机临床试验 (RCT) 的系统审查和元分析,将甲基酸与安慰剂或无干预相比较.
- 搜索了多个数据库 (CENTRAL,MEDLINE,Embase) 到2022年3月,包括试验注册表和制造商数据.
- 评估ADHD症状,严重和不严重的不良事件,一般行为和生活质量,使用试验序列分析 (TSA) 和GRADE方法来确定证据.
主要成果:
- 包括212个具有16,302名参与者的RCT; 41%的试验获得了制药资金,86%被评估为具有高偏差风险的试验.
- 甲基酸盐可能会改善老师评价的ADHD症状 (非常低的确定性证据) 和一般行为,但可能会增加非严重的不良事件 (例如,睡眠问题,食欲下降).
- 对于严重的不良事件或生活质量没有发现明确的影响,所有结果的证据确定性非常低.
结论:
- 甲基酸盐可能对儿童和青少年的ADHD症状和行为有好处,但证据的确定性非常低.
- 增加非严重不良事件的风险需要仔细考虑,影响的真实规模仍然不确定.
- 未来的研究应该专注于确定从甲基酸盐中受益最多/最少的子组,可能使用个人参与者数据和活性安慰剂来减轻偏差.
更多相关视频
05:48The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients
Published on: June 12, 2020
13:09Using Brain Activation nir-HEG/Q-EEG and Execution Measures CPTs in a ADHD Assessment Protocol
Published on: April 1, 2018
相关概念视频
Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
Adrenergic Agonists: Mixed-Action Agents
Ephedrine and pseudoephedrine lack a catecholamine group, making them less susceptible to degradation by metabolic enzymes. They have increased oral bioavailability and lipophilicity, resulting in a longer duration of action. Their response is reduced by...
Adrenergic Agonists: Therapeutic Uses
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
CNS Stimulants: Cocaine, Amphetamines and Cannabinoids
Antiasthma Drugs: Methylxanthines
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
