A Controlled Study of Nortriptyline in Children and Adolescents with Attention Deficit Hyperactivity Disorder
| Autor: | Timothy E. Wilens, Jefferson B. Prince, Rachael B. Millstein, David Polisner, Jeff Q. Bostic, Thomas J. Spencer, Joseph Biederman |
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| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent Nortriptyline Antidepressive Agents Tricyclic Placebo law.invention Double-Blind Method Randomized controlled trial law mental disorders medicine Humans Attention deficit hyperactivity disorder Pharmacology (medical) Child Psychiatry medicine.disease Discontinuation Psychiatry and Mental health Tolerability Attention Deficit Disorder with Hyperactivity Pediatrics Perinatology and Child Health Clinical Global Impression Anxiety Female medicine.symptom Psychology medicine.drug |
| Zdroj: | Journal of Child and Adolescent Psychopharmacology. 10:193-204 |
| ISSN: | 1557-8992 1044-5463 |
| Popis: | To study the efficacy and tolerability of nortriptyline (NT) in the treatment of pediatric attention deficit hyperactivity disorder (ADHD).Subjects were outpatient children and adolescents with ADHD ascertained from clinical referrals. Subjects were enrolled in a 6-week open study in which NT was titrated to 2 mg/kg/day as tolerated over 2 weeks. Using either a 30 % reduction in the ADHD rating scale or a score of 1 or 2 on the Clinical Global Impression (CGI) scale for ADHD improvement, responders to treatment were then randomized into a 3-week, controlled discontinuation phase. During this phase, subjects either continued on their current dose of NT or were tapered to placebo under double-blind conditions. Subjects were monitored for symptoms of ADHD, oppositionality, anxiety, and depression.Of the 35 subjects enrolled in the study, 32 completed the open phase and 23 completed the discontinuation phase. The mean dose of NT was 80 mg (1.8 mg/kg/day), resulting in a serum level of 81 ng/ml. At the conclusion of the open 6-week study, NT was related to a significant reduction in ADHD (p0.001) and oppositional symptoms (p0.001). At the conclusion of the discontinuation phase, the 12 subjects randomized to NT had significantly lower scores on the DSM-IV ADHD symptom checklist than those 11 subjects randomized to placebo (31 versus 21; t = 2.2; p0.04). No significant adverse events were observed, and children were noted to have weight gain during the trial.These data suggest that NT is effective in reducing symptoms not only of ADHD but also of oppositionality. This group of children and adolescents tolerated robust dosing of NT well, with few clinical or cardiovascular adverse events. |
| Databáze: | OpenAIRE |
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