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Übersichtsarbeit

Die Wirksamkeit von Stimulanzien-Retardpräparaten bei Kindern und Jugendlichen mit ADHD - eine systematische Übersicht

Published Online:September 01, 2006https://doi.org/10.1024/1422-4917.32.4.265

Abstract

Zusammenfassung: Stimulanzien sind das Mittel der Wahl zur pharmakologischen Behandlung einer Aufmerksamkeits-/Hyperaktivitätsstörung. Jedoch ist die Wirkdauer von schnell freisetzenden Präparaten oft nicht ausreichend. Mittlerweile wurden verschiedene retardierte Methylphenidat-, aber auch Amphetaminformen entwickelt, um die Probleme einer mehrfach täglichen Einnahme zu minimieren. Der Artikel stellt die klinischen Studien zu Wirksamkeit, Wirkdauer und Nebenwirkungsprofil verschiedener Stimulanzienformen dar. In der klinischen Anwendung sind die neuen Retard-Produkte wirkungsvolle Alternativen. Eine kontinuierliche mehrstufige Freisetzung des Wirkstoffs über den Tag verteilt nach einmaliger Medikamentengabe bietet Vorteile. Allerdings müssen Nebenwirkungen durch die verlängerte Wirkungsdauer genau beobachtet werden. Eine genauere Anpassung an die jeweiligen Erfordernisse der verschiedenen Tagesabschnitte und -bedürfnisse der Kinder und Jugendlichen ist schwierig. Die Erprobung von Titrierungsschemata unter Einbeziehung von schnell und verzögert freisetzenden Präparaten bleibt eine Aufgabe zukünftiger Forschung.


The Effectiveness of Stimulants of Retard Forms in Children and Adolescents with ADHD - a Systematic Overview

Summary: Stimulants are the matter of choice to treat attention deficit/ hyperactivity disorder (ADHD) pharmacologically. The period of effectiveness of immediate release stimulants is, however, often not satisfying. Currently a variety of retarded forms of methylphenidate and also amphetamine were developed in order to minimize the problems involved in a daily dose. This paper presents the clinical studies on effectiveness, period of effectiveness and the profile of side effects of different forms of stimulants. In the clinical practice the new retard products are effective alternatives. There is an advantage in giving this drug in a once daily single dose. At the same time, the side effects that are caused by an extended period of being effective have to be studied in detail. A more exact adaptation to the requirements of daily obligations and needs of children and adolescents is difficult to realize. Future research is supposed to test schemes of titration including immediate and sustained released stimulants.

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