Evaluation of the response of lisdexamfetamine in children and adolescents with ADHD: quasi-experimental study.

Introduction. Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders. Although lisdexamfetamine dimesylate (LDX) offers a treatment alternative, clinical evidence of LDX for ADHD has not been explored in Latin American pediatric population. Objective....

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Publicado en:Salud Mental Vol. 41; no. 6; pp. 279 - 286
Autores principales: Pérez Eduardo, Barragán, Juan Carlos, García Beristain, Gutiérrez Ricardo, Hidalgo
Formato: Artículo
Publicado: Instituto Nacional de Psiquiatria Ramon de la Fuente Nov/Dec2018
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      dt: Nov/Dec2018
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        10.17711/SM.0185-3325.2018.040
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        atl: Evaluation of the response of lisdexamfetamine in children and adolescents with ADHD: quasi-experimental study.
      aug:
        au:
          Pérez Eduardo, Barragán
          Juan Carlos, García Beristain
          Gutiérrez Ricardo, Hidalgo
        affil: Departamento de Neurología, Hospital Infantil de México Federico Gómez, Ciudad de México, México
      su:
        Attention-deficit hyperactivity disorder
        Children with attention-deficit hyperactivity disorder
        Youth with attention-deficit hyperactivity disorder
        Movement disorders
        Amphetamines
        Treatment of attention-deficit hyperactivity disorder
      sug:
        subj:
          Attention-deficit hyperactivity disorder
          Children with attention-deficit hyperactivity disorder
          Youth with attention-deficit hyperactivity disorder
          Movement disorders
          Amphetamines
          Treatment of attention-deficit hyperactivity disorder
      keyword:
        ADHD
        attention deficit
        lisdexamfetamine dimesylate
        motor hyperactivity
        déficit de atención
        dimesilato de lisdexanfetamina
        hiperactividad motora
        TDAH
      ab:
        Introduction. Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders. Although lisdexamfetamine dimesylate (LDX) offers a treatment alternative, clinical evidence of LDX for ADHD has not been explored in Latin American pediatric population. Objective. To evaluate the LDX response in Mexican pediatric patients with ADHD. Method. We designed a quasi-experimental, uncontrolled before and after study to evaluate the LDX response in patients with severe ADHD. We established a diagnosis of ADHD according to DSM-5 criteria. We formed three groups: without previous treatment (group A), in treatment with stimulant drugs (group B) or in treatment with non-stimulant drugs (group C). Prior to the start of the study, letters of consent and informed consent were signed. We evaluated the effect of LDX based on the difference between ADHD-RS scores at the beginning and after six months. Results. We recruited a total of 144 patients (group A: 48 patients, group B: 57 patients, group C: 39 patients). All the groups showed a significant decrease in the mean score of ADHD-RS (Attention Deficit Hyperactivity Disorder Rating Scale) at six months (group A 37.57 vs. 22.34, p <.01), (group B 36.72 vs. 24.45; p <. 01), (group C 38.54 vs. 24.3, p <.01). Fewer than 30% of the subjects showed a significant adverse reaction, the most frequent ones being: sleep disturbance (primary insomnia) 24% and decreased appetite in 20%. Discussion and conclusion. Treatment with LDX is an effective, well-tolerated pharmacological option for Mexican pediatric patients with ADHD.
        Introducción. El trastorno por déficit de atención con hiperactividad (TDAH) es uno de los trastornos del neurodesarrollo más comunes. Aunque el dimesilato de lisdexanfetamina (LDX) ofrece una alternativa de tratamiento, la evidencia clínica de LDX para TDAH no se ha explorado en población pediátrica latinoamericana. Objetivo. Evaluar la respuesta de LDX en pacientes pediátricos mexicanos con TDAH. Método. Diseñamos un estudio cuasiexperimental no controlado de antes y después para evaluar la respuesta de LDX en pacientes con TDAH grave. Establecimos el diagnóstico de TDAH de acuerdo con criterios del DSM-5. Conformamos tres grupos: sin tratamiento previo (grupo A), en tratamiento con fármacos estimulantes (grupo B) o en tratamiento con fármacos no estimulantes (grupo C). Previo al inicio del estudio se firmaron las cartas de consentimiento y asentimiento informado. Evaluamos el efecto de LDX con base en la diferencia de los puntajes de ADHD-RS al inicio y posterior a seis meses. Resultados. Reclutamos un total de 144 pacientes (grupo A: 48 pacientes, grupo B: 57 pacientes, grupo C: 39 pacientes). Todos los grupos mostraron una disminución significativa en la media de puntaje de ADHD-RS (Attention Deficit Hyperactivity Disorder Rating Scale) a los seis meses (grupo A 37.57 vs. 22.34; p < .01), (grupo B 36.72 vs. 24.45; p < .01), (grupo C 38.54 vs. 24.3; p < .01). Menos del 30% de los sujetos presentó alguna reacción adversa importante, siendo las más frecuentes: alteraciones del sueño (insomnio primario) 24% y disminución del apetito en 20%. Discusión y conclusión. El tratamiento con LDX es una opción farmacológica efectiva y bien tolerada para pacientes pediátricos mexicanos con TDAH.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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