درمان شش هفته اي با رباكستين در كودكان و نوجوانان مبتلا به اختلال پيش فعالي كم توجهي

Six week open-label reboxetine treatment in children and adolescents with attention deficit hyperactivity disorder

Background: Attention De fic it Hy perac tivity Diso rde r (ADHD) is a common psychiatric diso rder among childre n and ado lescents . This disorder causes difficu lties in aca de mic, be hav iora l, emot iona l, soc ial and famil y perform an ce, Stimulants show robust efficacy and a goo d safety profile in chi ld ren with this disorder, but a significa nt per cent ofADHD children do not respo nd adeq ua tely or cann ot tol erate the associa ted adverse effec ts wit h stim ulants . Such difficu lties highl ight the need for al te rna tive safe and effective medicati ons in the treatment of th is disorder. This open- label study assessed th e effectiveness of reboxet ine, a selec tive nor epin ephrine reuptake inhibitor, in chi ldre n and ado lescents with atten tio n defic it hyperacti vi ty disorder (ADHD). Methods: Fifteen child and ado lescent outpa tien ts, aged 7 to 16 (Mean± SD=9.72±2 7) years, diagnosed with ADHD were enro lled in a six open-label study wi th reboxet ine 4-6 mg/d. The principal measure of the outco me was the teacher and paren t Atte nt ion Defic it Hyperactive Disorder Rat ing Sca le (ADHD Rating Sca le) . Pa tie nts we re assessed by a ch ild psychiatri st at baseline, 2, 4 and 6 weeks of the medication star ted . Side effec ts questio nnaire was used to de tect s ide effects of reboxetin e. Repeated measures Analysis of variance (ANOVA) was do ne for comparison of Teacher and Paren t ADHD Ra ting Sca le scores duri ng the intervention . Results: Twelve of 15 (80%) partic ipa nts co mpleted the trea tment protocol. A sig nifican t decrease in ADHD symptoms on teac her (p=O.04) and parent (p=O .OOJ) ADHD rat ing scale was noted. Adverse effec ts we re mild to mod erate in severity . The most common adverse effec ts we re drowsiness/sedation and ap pet ite dec rease. Conclu sion: The results of the current study suggest the effectiveness of reb oxetine in the treatment of ADHD in chi ldre n and ado lescents . Double-b lind, placebo-co ntro lled studies and larger sample size with lon g duration of intervention are indicated to rigor ously test the efficacy of reboxe tine in ADJ-ID. It is import an t that future s tud ies comple te our knowledge about safety and side effects of reboxetine .