我儿子现在4岁2个多月,多动症症状明显,冲动型多动症的9个常见症状中,他符合8个,还有一个可能符合。所以上网了解了一下药物治疗的方式。择思达还没有研究,不过专注达在美国使用很广泛,相关的资料较多。
不知道各位家长给孩子吃专注达或者利他林都是多大的剂量,据我目前所了解到的信息,一般是每天早上复用1粒18mg,每天仅此一次。但是《医药经济报》2011年1月31日刊发的对三位相关专家的专访,却认为多动症一线用药哌甲酯:药量应达36~54mg/天。链接如下:http://www.yyjjb.com.cn/html/2011-01/31/content_135279.htm
为了确认此信息,我到美国FDA网站去找相关的介绍,在产品手册中,没有明确的说服用剂量是多少mg,但是明确的说了:每天服用2~3次。Ritalin is usually taken 2 to 3 times a day。http://www.fda.gov/downloads/Drugs/DrugSafety/UCM089090.pdf
在毒性学研究中,有下面的文字:
In a lifetime carcinogenicity study carried out in B6C3F1 mice, methylphenidate caused an
increase in hepatocellular adenomas and, in males only, an increase in hepatoblastomas, at a
daily dose of approximately 60 mg/kg/day. This dose is approximately 30 times and 4 times
the maximum recommended human dose on a mg/kg and mg/m2 basis, respectively.
Hepatoblastoma is a relatively rare rodent malignant tumor type. There was no increase in
total malignant hepatic tumors. The mouse strain used is sensitive to the development of
hepatic tumors, and the significance of these results to humans is unknown.
Methylphenidate did not cause any increases in tumors in a lifetime carcinogenicity
study carried out in F344 rats; the highest dose used was approximately 45 mg/kg/day, which
is approximately 22 times and 5 times the maximum recommended human dose on a mg/kg
and mg/m2 basis, respectively.
这两段文字表明:60 mg/kg/day是推荐剂量的30倍,45 mg/kg/day是推荐剂量的22倍,也就是说,推荐剂量是2mg/kg/day。那么一个体重为20kg的儿童(我儿子22kg),应该每天服用40mg,至少是2粒18mg的专注达或者利他林。http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/010187s069,018029s040,021284s011lbl.pdf
当然,FDA也不建议6岁以下儿童如用此药物。所以只好接着研究择思达了。。。
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