Venlafaxine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder

被引:19
作者
Findling, Robert L. [1 ]
Greenhill, Laurence L.
McNamara, Nora K.
Demeter, Christine A.
Kotler, Lisa A.
O'Riordan, Mary Ann
Myers, Carolyn
Reed, Michael D.
机构
[1] Case Western Reserve Univ, Case Western Reserve Univ Hosp, Med Ctr, Dept Psychiat, Cleveland, OH 44106 USA
[2] Case Western Reserve Univ, Case Western Reserve Univ Hosp, Med Ctr, Dept Pediat, Cleveland, OH 44106 USA
[3] Columbia Univ, Dept Psychiat, New York, NY USA
关键词
DEFICIT HYPERACTIVITY DISORDER; DEPRESSED CHILDREN; OPEN TRIAL; PAROXETINE; SCHEDULE; ADULTS; METHYLPHENIDATE; SCHIZOPHRENIA; OXIDATION; CYP2D6;
D O I
10.1089/cap.2007.0119
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: The objectives of this pilot study were to explore the changes in symptom severity, tolerability, and the pharmacodynamics of venlafaxine treatment in youths with attention-deficit/ hyperactivity disorder (ADHD). Methods: This was a 2-week, open-label, outpatient trial of venlafaxine in children and adolescents, ages 5-17 years, with ADHD. Three dosing strata, 0.5, 1.0, and 2.0 mg/kg per day, were examined. ADHD symptom severity and improvement assessments included the ADHD Rating Scale (ARS-IV) and the Clinical Global Impressions Scale (CGI). During this study, venlafaxine, O-desmethylvenlafaxine (ODV), norepinephrine, and serotonin concentrations were obtained. Results: Thirty-eight participants (33 males) were treated in this trial. Overall, parent-completed and teacher-completed ARS-IV total scores showed a statistically significant positive change at the end of the study when compared to baseline (p < 0.05). Significant increases in plasma venlafaxine concentrations were observed at day 15 when compared to day 8 (p = 0.04). In addition, plasma norepinephrine and serotonin concentrations were found to be significantly decreased from baseline at end of study (p < 0.05). Four patients ended participation in the study prematurely: lost to follow up (n = 2), withdrawal of consent (n = 1), and worsening of ADHD symptoms after 8 days of treatment (n = 1). There were no discontinuations due to other adverse events. Conclusions: Venlafaxine appeared to offer some benefit and appears to be relatively safe for the short-term treatment of ADHD in this open-label trial. The pharmacodynamics of venlafaxine in youths are consistent with serotonergic and neuradrenergic modulation.
引用
收藏
页码:433 / 445
页数:13
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