주의력결핍과잉행동장애 아동에서 2차 선택제로서의 Bupropion의 효능 및 부작용에 대한 예비적 연구

A Preliminary Study of the Efficacy and Safety of Bupropion as the Second-Line Drug in Children with Attention Deficit Hyperactivity Disorder

  Objectives : This study was aimed to examine the efficacy and safety of bupropion in methylphenidate-inapplicable children with attention deficit hyperactivity disorder (ADHD) due to insufficient treatment response or intolerable adverse effects. Methods : Twelve children (8.8±2.1 years, 10 boys, total IQ 105.3±10.7) were recruited for this study from September 2004 to August 2005. ADHD was confirmed by K-SADS-PL. The efficacy was assessed by ADHD rating scale (ADHDRS) for investigator, Conner’s parental rating scale-revised (CPRS-R), ADHDRS school version, clinical global impression (CGI), and computerized neurocognitive function test. 168.8 ㎎ (SD=85.4 ㎎) of bupropion was medicated for 37.4 days (SD=8.7 days). Results : Total score of ADHDRS assessed by investigator (p=0.018), CGI-S score (p=0.026), CPRS-R score (p=0.018), total score (p=0.027) and inattentive score (p=0.041) of ADHDRS school version were significantly decreased after bupropion application. Six subjects (50%) were assessed as “very much improved” or “much improved” by CGI-Improvement in the end of trial. Response time of word color test was also significantly decreased after medication (p=0.043). Decreased appetite (2 subjects), weight loss (1 subject), insomnia (1 subject), anxiety (1 subject), and nausea (1 subject) were observed during this study period. Conclusion : Bupropion was effective and well-tolerated for the methylphenidateinapplicable children with ADHD.