Abstract:
BACKGROUND:Responses to atomoxetine vary for individual patients with attention-deficit/hyperactivity disorder (ADHD). However, we do not know whether any factors can be used to reliably predict how individuals with ADHD will respond to treatment. OBJECTIVE:Our objective was to evaluate background variables that facilitate early identification of those adults with ADHD who are likely to respond to treatment with atomoxetine. METHODS:We pooled data for atomoxetine-treated adults with ADHD from 12 clinical trials for a short-term (10-week) analysis, and from 11 clinical trials for a long-term (24-week) analysis. Patients not meeting a response definition [≥30 % reduction in Conners' Adult ADHD Rating Scales-Investigator Rated: Screening Version (CAARS-Inv:SV) total score and Clinical Global Impressions of ADHD Severity Scale (CGI-S) score ≤3 at endpoint], or who discontinued, were defined as non-responders. Another definition of response (≥30 % reduction in CAARS-Inv:SV total score at endpoint) was also used in these analyses; only the results with the former definition are shown in this abstract, as the same conclusions were gained with both definitions. A treatment-specified subgroup detection tool (a resampling-based ensemble tree method) was used to identify predictors of response. RESULTS:Of 1945 adults in the long-term analysis, 548 (28.2 %) were responders to atomoxetine at week 24; 65.2 % of 1397 non-responders had discontinued. Of 4524 adults in the short-term analysis, 1490 (32.9 %) were responders at week 10; 33.2 % of 1006 non-responders had discontinued. No analyzed baseline parameters (age, sex, prior stimulant use, ADHD subtype, CAARS-Inv:SV, CGI-S) were statistically significant predictors of response. Reductions in CAARS-Inv:SV total, CAARS-Inv:SV subscores, and CGI-S at week 4 in the short-term analysis, and at weeks 4 or 10 in the long-term analysis, were statistically significant predictors of response, i.e., patients with versus without these reductions early in treatment were more likely to be clinical responders at later time points. Sensitivity ranged from 28.6 to 85.9 %, and specificity ranged from 23.8 to 86.7 %. Predictors with higher sensitivity had lower specificity, and vice versa. CONCLUSIONS:Reductions in CAARS-Inv:SV and CGI-S scores at weeks 4 and 10 are statistically significant predictors of response to atomoxetine at later time points in adults with ADHD. However, the predictors identified by these analyses are not reliable enough for use in clinical practice. The only currently available method to judge whether individuals with ADHD will respond to atomoxetine is to start treatment and assess the response over an extended period, sometimes longer than 10 weeks.
journal_name
CNS Drugsjournal_title
CNS drugsauthors
Bushe C,Sobanski E,Coghill D,Berggren L,De Bruyckere K,Leppämäki Sdoi
10.1007/s40263-016-0323-xsubject
Has Abstractpub_date
2016-04-01 00:00:00pages
317-34issue
4eissn
1172-7047issn
1179-1934pii
10.1007/s40263-016-0323-xjournal_volume
30pub_type
临床试验,杂志文章相关文献
CNS DRUGS文献大全abstract::Topiramate is an antiepileptic drug that has a broad spectrum of antiseizure effects, which appear to be the result of several neurostabilising pharmacological mechanisms. These include blockade of ion channels, potentiation of GABA neuroinhibition and glutamate receptor antagonism at non-NMDA receptors, as well as mi...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200317130-00007
更新日期:2003-01-01 00:00:00
abstract::Satisfactory management of Parkinson's disease is a challenge that requires a tailored approach for each individual. In the advanced phase of the disease, patients may experience motor complications despite optimized pharmacological therapy. Apomorphine, a short-acting D1- and D2-like receptor agonist, is the only dru...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-019-00661-z
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Although levodopa is considered the most effective pharmacotherapy for motor symptoms of Parkinson's disease (PD), chronic use is associated with motor complications, including fluctuating response and unpredictable, involuntary movements called dyskinesia. ADS-5102 (amantadine) extended-release (ER) capsule...
journal_title:CNS drugs
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40263-018-0498-4
更新日期:2018-04-01 00:00:00
abstract::The anilidopiperidine opioid remifentanil has pharmacodynamic properties similar to all opioids; however, its pharmacokinetic characteristics are unique. Favourable pharmacokinetic properties, minimally altered by extremes of age or renal or hepatic dysfunction, enable easy titration and rapid dissipation of clinical ...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200418150-00004
更新日期:2004-01-01 00:00:00
abstract::The original article can be found online. ...
journal_title:CNS drugs
pub_type: 杂志文章,已发布勘误
doi:10.1007/s40263-018-0561-1
更新日期:2018-09-01 00:00:00
abstract::An explosion in antiepileptic drug (AED) therapy began in the 1990s with the licensing of 9 new chemical entities and more to come. Important differences between AEDs may not be detected by regulatory trials, which are designed to satisfy licensing requirements and often diverge considerably from everyday clinical pra...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200115010-00001
更新日期:2001-01-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Haemorrheological parameters and endothelial function are known to be altered in vascular diseases, including stroke. Treatment with HMG-CoA reductase inhibitors ('statins') improves cerebrovascular (and cardiovascular) morbidity and mortality in patients with atherosclerosis; the beneficial ...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.2165/00023210-200418030-00003
更新日期:2004-01-01 00:00:00
abstract:INTRODUCTION:Intranasal (IN) insulin acutely improves verbal memory in mild cognitive impairment (MCI)/Alzheimer's disease (AD), but its therapeutic effects may be attenuated in apolipoprotein E4 (ApoE4) carriers. Furthermore, rapid-acting (RA) insulins may have superior therapeutic effects compared with regular insuli...
journal_title:CNS drugs
pub_type: 杂志文章,随机对照试验
doi:10.1007/s40263-014-0214-y
更新日期:2014-12-01 00:00:00
abstract::Attention-deficit/hyperactivity disorder, or ADHD, is the most frequently occurring neurobiological disorder in childhood and is defined by symptoms of inattention and/or hyperactivity and impulsivity that are excessive when compared with other individuals at the same developmental level. ADHD can be successfully trea...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-013-0130-6
更新日期:2014-02-01 00:00:00
abstract::Biopharmaceuticals can induce antibodies, which interact with and neutralize the therapeutic effect of such drugs and are therefore termed neutralizing antibodies (NAbs). In the treatment of multiple sclerosis, NAbs against interferon (IFN)-beta and natalizumab have been recognized. The prevalence of NAbs against diff...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200923050-00003
更新日期:2009-01-01 00:00:00
abstract::Antipsychotic polypharmacy refers to the co-prescription of more than one antipsychotic drug for an individual patient. Surveys of prescribing in psychiatric services internationally have identified the relatively frequent and consistent use of combined antipsychotics, usually for people with established schizophrenia...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/11587810-000000000-00000
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:No head-to-head clinical trials have been published comparing guanfacine extended release (GXR) and atomoxetine (ATX): two nonstimulants approved for the treatment of attention-deficit/hyperactivity disorder (ADHD). However, other study designs or methods could be used to indirectly compare these two medicat...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.1007/s40263-013-0102-x
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Walking impairment is a hallmark of multiple sclerosis (MS). It affects > 90% of individuals over time, reducing independence and negatively impacting health-related quality of life, productivity, and daily activities. Walking impairment is consistently reported as one of the most distressing impairments by ...
journal_title:CNS drugs
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s40263-018-0586-5
更新日期:2019-01-01 00:00:00
abstract::In this article, we review the evidence that tocopherol (vitamin E) may have a role to play in the prevention and treatment of Alzheimer's disease and other neurological diseases. The theoretical rationale for the effectiveness of tocopherol as treatment and/or prevention of Alzheimer's disease is based on its antioxi...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200418120-00005
更新日期:2004-01-01 00:00:00
abstract::Bulimia nervosa is an eating disorder characterised by recurrent episodes of binge eating and associated efforts to purge the ingested calories through self-induced vomiting, laxative or diuretic abuse, fasting or intensive exercise. The aetiopathogenesis and pathophysiology of the disorder are currently unclear. Biol...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200115020-00004
更新日期:2001-01-01 00:00:00
abstract::Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that is pathologically characterized by inflammatory demyelination and neurodegeneration. Axonal damage, along with neuronal loss, occurs from disease onset and may lead to progressive and permanent disability. In contrast with the inflam...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-013-0093-7
更新日期:2013-10-01 00:00:00
abstract::Numerous in vitro and in vivo experimental animal studies have demonstrated that gangliosides, particularly GMI ganglioside (siagoside), may stimulate or accelerate the repair of peripheral and central nervous system neurons after various types of damage. Clinical studies of GMl in peripheral neuropathies and stroke, ...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.2165/00023210-199401030-00006
更新日期:1994-03-01 00:00:00
abstract::Naltrexone is a μ-opioid receptor antagonist that blocks the euphoric effects of heroin and prescription opioids. In order to improve treatment adherence, a once-monthly, intramuscular, extended-release formulation of naltrexone (XR-NTX) [VIVITROL(®)] has been developed, and approved in the USA and Russia for the prev...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-013-0110-x
更新日期:2013-10-01 00:00:00
abstract::Oral blonanserin (Lonasen) is an atypical antipsychotic agent indicated for use in patients with schizophrenia in Japan and Korea. It is effective in the treatment of patients with schizophrenia, providing short- and long-term efficacy against both the positive and negative symptoms of the disorder in several randomiz...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/11202620-000000000-00000
更新日期:2010-01-01 00:00:00
abstract::Existing drug delivery methods have not led to a significant increase in survival for patients with malignant primary brain tumors. While the combination of conventional therapies consisting of surgery, radiotherapy, and chemotherapy has improved survival for some types of brain tumors (e.g., WNT medulloblastoma), oth...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-020-00766-w
更新日期:2020-11-01 00:00:00
abstract::As in all patient populations, epilepsy is common in pregnant women. Consequently, approximately 1 in 200 pregnancies is exposed to antiepileptic drugs (AEDs). Although exposure to AEDs in utero has been associated with an increased risk of major fetal malformations, most women with epilepsy require medication through...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200620100-00001
更新日期:2006-01-01 00:00:00
abstract::Restless legs syndrome (RLS) is a common, frequently chronic, sensorimotor neurological disorder characterized by nocturnal leg dysesthesias and an irresistible urge to move the legs, usually resulting in sleep disturbance. Dopaminergic agonists, alpha-2-delta calcium-channel ligands, and opioids have all demonstrated...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-015-0250-2
更新日期:2015-05-01 00:00:00
abstract::Major depressive disorder (MDD) is a chronic, recurrent mental disease that causes serious disability. Because currently available antidepressants have limited efficacy with respect to response and remission in patients with MDD, clinicians must choose the best available treatment interventions for patients who do not...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-012-0032-z
更新日期:2013-05-01 00:00:00
abstract::The kynurenine pathway constitutes the main route of tryptophan degradation and generates the production of several neuroactive compounds; quinolinic acid is an excitotoxic NMDA receptor agonist, 3-hydroxykynurenine is a free-radical generator and kynurenic acid (KYNA) is an antagonist at glutamate and nicotinic recep...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200923020-00001
更新日期:2009-01-01 00:00:00
abstract::Alzheimer's disease (AD) is the most prevalent dementia in the world. Its cause(s) are presently largely unknown. The most common explanation for AD, now, is the amyloid cascade hypothesis, which states that the cause of AD is senile plaque formation by the amyloid β peptide, and the formation of neurofibrillary tangl...
journal_title:CNS drugs
pub_type: 杂志文章
doi:10.1007/s40263-020-00737-1
更新日期:2020-07-01 00:00:00
abstract::A number of news items and case reports describing complex behaviours (e.g. sleep driving, sleep cooking, sleep eating, sleep conversations, sleep sex) associated with the use of hypnosedative medications have recently received considerable attention. Regulatory agencies examining these reports have subsequently issue...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/0023210-200822120-00005
更新日期:2008-01-01 00:00:00
abstract::Aripiprazole (Abilify(®)) is an atypical antipsychotic that is widely used in the treatment of psychiatric conditions. Unlike other currently available atypical antipsychotics that primarily have varying degrees of dopamine D2 receptor antagonism, aripiprazole is a partial agonist at D2 and serotonin 5-HT1A receptors,...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-013-0134-2
更新日期:2014-02-01 00:00:00
abstract::The basal ganglia and dopaminergic pathways play a central role in hyperkinetic movement disorders. Vesicular monoamine transporter 2 (VMAT2) inhibitors, which deplete dopamine at presynaptic striatal nerve terminals, are a class of drugs that have long been used to treat hyperkinetic movement disorders, but have rece...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.1007/s40263-018-0580-y
更新日期:2018-12-01 00:00:00
abstract::Treatment-resistant depression (TRD) presents major challenges for both patients and clinicians. There is no universally accepted definition of TRD, but results from the US National Institute of Mental Health's (NIMH) STAR*D (Sequenced Treatment Alternatives to Relieve Depression) programme indicate that after the fai...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/11530280-000000000-00000
更新日期:2010-02-01 00:00:00
abstract::The aim of this review is to provide clinicians with a picture of the mechanisms by which: histamine and histaminergic agonists act on the vestibular system both peripherally and centrally; and histaminergic agonists and antagonists interfere with the recovery process after peripheral vestibular lesion. We have focuse...
journal_title:CNS drugs
pub_type: 杂志文章,评审
doi:10.2165/00023210-200115110-00004
更新日期:2001-01-01 00:00:00