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Klin Padiatr 2008; 220(2): 93-100
DOI: 10.1055/s-2007-985864
Übersichtsartikel

© Georg Thieme Verlag KG Stuttgart · New York

Methylphenidat-Retard-Präparate bei Kindern und Jugendlichen mit ADHs - eine Übersicht

Methylphenidate of Retard Forms in Children and Adolescents with ADHD - an OverviewR. Pelz 1 , T. Banaschewski 1 , K. Becker 1
  • Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters am Zentralinstitut für Seelische Gesundheit, Mannheim
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Publication History

Publication Date:
21 December 2007 (online)

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Zusammenfassung

Zum jetzigen Zeitpunkt sind Stimulanzien das Mittel der Wahl zur pharmakologischen Behandlung einer Aufmerksamkeits-/Hyperaktivitätsstörung (ADHS). Sie sind indiziert, wenn verhaltenstherapeutische und psychoedukative Maßnahmen alleine nicht ausreichen. Die Wirkdauer von schnell freisetzenden Präparaten ist oft nicht ausreichend. Mittlerweile wurden verschiedene retardierte Methylphenidatpräparate entwickelt und auch für den deutschen Markt zugelassen. Der Artikel gibt eine Übersicht über die klinischen Studien zu Wirksamkeit, Wirkdauer und Nebenwirkungsprofil der in Deutschland erhältlichen Darreichungsformen von Stimulanzien. In der klinischen Anwendung sind die neuen Retard-Produkte wirkungsvolle Alternativen, da die kontinuierliche mehrstufige Freisetzung des Wirkstoffs über den Tag verteilt nach morgendlicher Einmalgabe Vorteile bietet. Allerdings müssen unerwünschte Arzneimittelwirkungen durch die verlängerte Wirkungsdauer genau beobachtet werden. Eine individuelle Anpassung an die jeweiligen Erfordernisse der verschiedenen tageszeitabhängigen Bedürfnisse der Kinder und Jugendlichen ist erforderlich. Möglicherweise kann eine Kombination mit unretardiertem MPH zu einer besseren Wirkungs-/Nebenwirkungsrelation führen.

Abstract

As yet, stimulants remain the preferred means of treating attention-deficit/hyperactivity disorder (ADHD) pharmacologically. They are indicated when measures based on behavioural therapy or psychoeducation alone are not sufficient. How-ever, the period of effectiveness of immediate release stimulants is often not satisfactory. A variety of retarded forms of methylphenidate have now been developed and approved for the German market. This paper presents an overview of clinical studies on effectiveness, period of effectiveness and the profile of side effects of different forms stimulants available in Germany. In clinical practice, the new retard products represent effective alternatives. There is an advantage in administering this drug in a once-daily single dose. At the same time, the side effects that are caused by an extended period of effectiveness have to be studied in detail. A more precise adaptation to the daily obligations and needs of children and adolescents is needed. Possibly, a combination with unretareded MPH might lead to a better effect/side-effect profile.

Schlüsselwörter

ADHS - Pharmakotherapie - Methylphenidat - Retardformen - Psychostimulanzien - Nebenwirkungen

Key words

ADHD - pharmacotherapy - methylphenidate - retarded forms of methylphenidate side effects

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Korrespondenzadresse

Dr. R. Pelz

Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters am Zentralinstitut für Seelische Gesundheit

Postfach 12 21 20

68072 Mannheim

Phone: +49/621/1703 45 41

Fax: +49/621/1703 45 05

Email: reta.pelz@zi-mannheim.de