Gastrointestinale bivirkninger under behandling med metylfenidat av barn og ungdom med ADHD: Systematisk oversikt og metaanalyse

Gastrointestinal adverse events during methylphenidate treatment of children and adolescents with attention deficit hyperactivity disorder: A systematic review with meta-analysis and Trial Sequential Analysis of randomised clinical trials

Forfattere
Holmskov, M. Storebo, O. J. Moreira-Maia, C. R. Ramstad, E. Magnusson, F. L. Krogh, H. B. Groth, C. Gillies, D. Zwi, M. Skoog, M. Gluud, C. Simonsen, E.
Årstall
2017
Tidsskrift
PLoS ONE [Electronic Resource]
Volum
12
Sider
e0178187
OBJECTIVES: To study in more depth the relationship between type, dose, or duration of methylphenidate offered to children and adolescents with attention deficit hyperactivity disorder and their risks of gastrointestinal adverse events based on our Cochrane systematic review. METHODS AND FINDINGS: We use data from our review including 185 randomised clinical trials. Randomised parallel-group trials and cross-over trials reporting gastrointestinal adverse events associated with methylphenidate were included. Data were extracted and quality assessed according to Cochrane guidelines. Data were summarised as risk ratios (RR) with 95% confidence intervals (CI) using the inverse variance method. Bias risks were assessed according to domains. Trial Sequential Analysis (TSA) was used to control random errors. Eighteen parallel group trials and 43 cross-over trials reported gastrointestinal adverse events. All trials were at high risk of bias. In parallel group trials, methylphenidate decreased appetite (RR 3.66, 95% CI 2.56 to 5.23) and weight (RR 3.89, 95% CI 1.43 to 10.59). In cross-over trials, methylphenidate increased abdominal pain (RR 1.61, 95% CI 1.27 to 2.04). We found no significant differences in the risk according to type, dose, or duration of administration. The required information size was achieved in three out of four outcomes. CONCLUSION: Methylphenidate increases the risks of decreased appetite, weight loss, and abdominal pain in children and adolescents with attention deficit hyperactivity disorder. No differences in the risks of gastrointestinal adverse events according to type, dose, or duration of administration were found.

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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

ADHD

Biologiske risikofaktorer, sykdommer og symptomer

Bivirkninger/uønskede effekter

Tiltak

Medikamentell behandling

Stimulerende midler

Aldersgruppe

Barn i førskolealder (3-5 år)

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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