PURPOSE:Young adults with ADHD have been shown to be at increased risk for impairment in driving behaviors. Although stimulant medications have proven efficacy in reducing ADHD symptomatology, there is limited knowledge as to their effects on driving behavior. The focus of this report is on assessing the impact of lisdexamfetamine dimesylate (LDX) on driving behaviors in young adults with ADHD using a validated driving behavior questionnaire. METHODS:This assessment was carried out in the context of a randomized, double-blind, 6-week, placebo-controlled, parallel-design study of LDX versus placebo. Subjects were 61 outpatients of both sexes, 18-26 years of age, who met Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for ADHD. Subjects were randomized to receive LDX or placebo for 6 weeks. Driving behavior was assessed at baseline and at the end of treatment using a U.S. version of the Manchester Driving Behavior Questionnaire (DBQ). RESULTS:Highly significant improvements were documented on LDX, over placebo, in driving behaviors assessed through the DBQ in measures of driving errors, driving lapses, and a trend toward fewer driving violations. There were no meaningful associations between these DBQ results and previously documented changes in a laboratory driving simulation paradigm or with improvement in symptoms of ADHD assessed through the ADHD rating scale. CONCLUSIONS:LDX treatment was associated with significant improvements in self-reported driving behaviors that were independent of improvement in symptoms of ADHD. These results suggest that LDX may reduce behaviors associated with driving risks in young adults with ADHD.

译文

目的:已证明患有多动症的年轻成年人驾驶行为受损的风险增加。尽管刺激性药物已被证明能有效减轻ADHD症状,但对其驾驶行为的影响知之甚少。本报告的重点是使用经过验证的驾驶行为调查表评估赖氨苯丙胺二甲磺酸酯(LDX)对患有ADHD的年轻成年人的驾驶行为的影响。
方法:本评估是在LDX与安慰剂进行的随机,双盲,6周,安慰剂对照,平行设计研究的背景下进行的。受试者为61名年龄在18-26岁之间的男女门诊患者,均符合《精神障碍诊断和统计手册》(第四版)中关于多动症的标准。受试者随机接受LDX或安慰剂治疗6周。使用美国版的曼彻斯特驾驶行为问卷(DBQ)在基线和治疗结束时评估驾驶行为。
结果:与安慰剂相比,LDX记录了通过DBQ评估的驾驶行为(衡量驾驶错误,驾驶失误以及减少驾驶违规的趋势)的显着改善。这些DBQ结果与先前记录的实验室驾驶模拟范式变化或通过ADHD评分量表评估的ADHD症状改善之间没有有意义的关联。
结论:LDX治疗与自我报告的驾驶行为显着改善有关,而自我报告的驾驶行为与ADHD症状的改善无关。这些结果表明,LDX可以减少与多动症年轻成年人驾驶风险相关的行为。

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