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