Efectividad cognitiva del metilfenidato y de la atomoxetina en el trastorno por déficit de atención con hiperactividad:una revisión

  1. Belén Rubio 1
  2. Sergio Hernández 2
  3. Oscar Herreros 3
  4. Xavier Gastaminza 4
  5. Rosario Cejas 5
  6. Jennifer Castrillo 6
  1. 1 Facultativo especialista en Psiquiatría. Unidad de Interconsul-ta y Enlace de Psiquiatría Infanto-Juvenil, Hospital Universita-rio de Canarias, La Laguna
  2. 2 Profesor Titular de Neuropsicología. Dpto. Psicología Clí-nica, Psicobiología y Metodología. Facultad de Ciencias de la Salud, Sección de Psicología y Logopedia, Universidad de La Laguna
  3. 3 Psiquiatra Facultativo especialista de Área. Unidad de Salud Mental Infanto-Juvenil. Hospital Universitario Virgen de las Nieves, Granada
  4. 4 Facultativo especialista en Psiquiatría. NOVOMEDIGRUP. Paidopsiquiatría psicosomática. Unidad de Paidopsiquiatría. Hospital Universitari Vall d’Hebron, Barcelona. Universitat Autonoma de Barcelona
  5. 5 Facultativo especialista en Psiquiatría. Hospital Universitario de Canarias, La Laguna
  6. 6 Psicóloga. Dpto. Psicología Clínica, Psicobiología y Metodo-logía. Facultad de Ciencias de la Salud, Sección de Psicología, Universidad de La Laguna
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Revista:
Revista de Psiquiatría Infanto-Juvenil

ISSN: 2660-7271,  1130-9512

Año de publicación: 2016

Volumen: 33

Número: 3

Páginas: 367-377

Tipo: Artículo

DOI: 10.31766/REVPSIJ.V33N3A1 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Revista de Psiquiatría Infanto-Juvenil

Resumen

Introducción. El Trastorno por Déficit de Atención con Hiperactividad (TDAH) se asocia a importantes déficits en diversos dominios cognitivos. Dicha afirmación cuenta con evidencias cognitivo-conductuales y neurofuncionales. El tratamiento farmacológico indicado en esta población tiene como objetivo fundamental suprimir o reducir la sintomatología nuclear del trastorno. Esta es la diana terapéutica tanto del Metilfenidato como de la Atomoxetina. Ambos actúan sobre la corteza prefrontal y sus conexiones con los ganglios basales, parte del sustrato anatómico de la atención, la actividad motora y el control inhibitorio. Considerando que estas regiones forman parte del conjunto de áreas y circuitos implicados en el procesamiento cognitivo complejo, se puede colegir que los acercamientos farmacológicos eficaces en la mejora de la sintomatología nuclear de este trastorno tendrán un efecto beneficioso sobre la ejecución cognitiva de estos pacientes, y, por extensión, sobre el rendimiento académico.Objetivo. Actualizar los conocimientos existentes en neurociencia sobre la repercusión cognitiva de la administración de Metilfenidato y Atomoxetina en población con TDAH. Es un interés central del estudio profundizar en la relación entre sintomatología nuclear, sustrato anatomopatológico y rendimiento cognitivo, con especial referencia a las funciones ejecutivas.Método. Se ha realizado una exhaustiva revisión bibliográfica en la bases Pubmed, PsycINFO y Medline con las palabras clave: Metilfenidato, Atomoxetina, TDAH, Tratamiento, Evaluación neuropsicológica y Neuropsicología infantil.Conclusiones. El metilfenidato ha mostrado superioridad a la atomoxetina en el control de la sintomatología nuclear. Sin embargo, sobre el funcionamiento cognitivo, y en especial sobre la memoria de trabajo, ambos fármacos muestran efectos beneficiosos comparables.

Referencias bibliográficas

  • Catalá-López F, Peiró S, Ridao M, Sanfélix-Gimeno G, Gènova-Maleras R, Catalá MA. Prevalence of attention deficit hyperactivity disorder among children and adolescents in Spain: a systematic review and meta-analysis of epidemiological studies. BMC Psychiatry. 2012;12(1):168.
  • Willcutt EG. The prevalence of DSM-IV attentiondeficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics. 2012;9(3):490–9.
  • Solanto MV, Abikoff H, Sonuga-Barke E, Schachar R, Logan GD, Wigal T, et al. The ecological validity of delay aversion and response inhibition as measures of impulsivity in AD/HD: a supplement to the NIMH multimodal treatment study of AD/HD. J Abnorm Child Psychol. 2001;29(3):215–28.
  • Escobar R. Worse quality of life for children with newly diagnosed attention-deficit/hyperactivity disorder, compared with asthmatic and healthy children. Pediatrics. 2005;116(3):e364–9.
  • Brown TE, Reichel PC, Quinlan DM. Executive function impairments in high IQ adults with ADHD. J Atten Disord. 2009;13(2):161–7.
  • Maziade M, Rouleau N, Lee B, Rogers A, Davis L, Dickson R. Atomoxetine and neuropsychological function in children with attention-deficit/hyperactivity disorder: results of a pilot study. J Child Adolesc Psychopharmacol. 2009;19(6):709–18.
  • Pliszka SR. The neuropsychopharmacology of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57(11):1385–90.
  • Biederman J. Attention-deficit/hyperactivity disorder: A selective overview. Biol Psychiatry. 2005;57(11):1215–20.
  • Biederman J, Faraone SV. Attention-deficit hyperactivity disorder. Lancet; 366(9481):237–48.
  • Swanson JM, Wigal SB, Udrea D, Lerner M, Agler D, Flynn D, et al. Evaluation of individual subjects in the analog classroom setting: I. Examples of graphical and statistical procedures for withinsubject ranking of responses to different delivery patterns of methylphenidate. Psychopharmacol Bull. 1998;34(4):825–32.
  • Wolraich ML, Greenhill LL, Pelham W, Swanson J, Wilens T, Palumbo D, et al. Randomized, controlled trial of oros methylphenidate once a day in children with attention-deficit/hyperactivity disorder. Pediatrics. 2001;108(4):883–92.
  • Swanson J, Baler RD, Volkow ND. Understanding the effects of stimulant medications on cognition in individuals with attention-deficit hyperactivity disorder: a decade of progress. Neuropsychopharmacology. 2011;36(1):207–26.
  • Starr HL, Kemner J. Multicenter, randomized, open-label study of OROS methylphenidate versus atomoxetine: treatment outcomes in African-American children with ADHD. J Natl Med Assoc. 2005;97(10 Suppl):11S–16S.
  • Newcorn JH, Kratochvil CJ, Allen AJ, Casat CD, Ruff DD, Moore RJ, et al. Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder: acute comparison and differential response. Am J Psychiatry. 2008;165(6):721–30.
  • DuPaul GJ, Barkley RA, McMurray MB. Response of children with ADHD to methylphenidate: interaction with internalizing symptoms. J Am Acad Child Adolesc Psychiatry. ;33(6):894–903
  • Psychopathology C, Edition S, Mash EJ, Barkley RA, Barkley RA. Attention-Deficit/ Hyperactivity Disorder. 2003
  • Castellanos FX, Tannock R. Neuroscience of attention-deficit/hyperactivity disorder: the search for endophenotypes. Nat Rev Neurosci. 2002;3(8):617–28.
  • Oades RD, Sadile AG, Sagvolden T, Viggiano D, Zuddas A, Devoto P, et al. The control of responsiveness in ADHD by catecholamines: Evidence for dopaminergic, noradrenergic and interactive roles. Dev Sci. 2005;8(2):122–31.
  • Sonuga-Barke EJS. Causal models of attentiondeficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biol Psychiatry. 2005;57(11):1231–8.
  • Wilens TE, Biederman J. The stimulants. Psychiatr Clin North Am. 1992;15(1):191–222.
  • Sonuga-Barke EJS, Coghill D, Wigal T, DeBacker M, Swanson J. Adverse reactions to methylphenidate treatment for attention-deficit/hyperactivity disorder: structure and associations with clinical characteristics and symptom control. J Child Adolesc Psychopharmacol. 2009;19(6):683–90.
  • Barkley RA, McMurray MB, Edelbrock CS, Robbins K. Side effects of methylphenidate in children with attention deficit hyperactivity disorder: a systemic, placebo-controlled evaluation. Pediatrics. 1990;86(2):184–92.
  • Pietrzak RH, Mollica CM, Maruff P, Snyder PJ. Cognitive effects of immediate-release methylphenidate in children with attention-deficit / hyperactivity disorder. 2006;30:1225–45.
  • Aron AR, Dowson JH, Sahakian BJ, Robbins TW. Methylphenidate improves response inhibition in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2003;54(12):1465–8.
  • Aron AR, Robbins TW, Poldrack RA. Inhibition and the right inferior frontal cortex: one decade on. Trends Cogn Sci. 2014;18(4):177–85.
  • Rhodes SM, Coghill DR, Matthews K. Neuropsychological functioning in stimulantnaive boys with hyperkinetic disorder. Psychol Med. 2005;35(8):1109–20.
  • Rhodes SM, Coghill DR, Matthews K. Methylphenidate restores visual memory, but not working memory function in attention deficithyperkinetic disorder. Psychopharmacology (Berl). 2004;175(3):319–30.
  • Vance A, Ferrin M, Winther J, Gomez R. Examination of spatial working memory performance in children and adolescents with attention deficit hyperactivity disorder, combined type (ADHD-CT) and anxiety. J Abnorm Child Psychol. 2013;41(6):891–900.
  • Smith AB, Taylor E, Brammer M, Halari R, Rubia K. Reduced activation in right lateral prefrontal cortex and anterior cingulate gyrus in medication-naïve adolescents with attention deficit hyperactivity disorder during time discrimination. J Child Psychol Psychiatry. 2008;49(9):977–85.
  • Smith A, Cubillo A, Barrett N, Giampietro V, Simmons A, Brammer M, et al. Neurofunctional effects of methylphenidate and atomoxetine in boys with attention-deficit/hyperactivity disorder during time discrimination. Biol Psychiatry. 2013;74(8):615–22.
  • Vaidya CJ, Austin G, Kirkorian G, Ridlehuber HW, Desmond JE, Glover GH, et al. Selective effects of methylphenidate in attention deficit hyperactivity disorder: a functional magnetic resonance study. Proc Natl Acad Sci. 1998;95(24):14494–9.
  • Pauls AM, Daly OG, Rubia K, Riedel WJ, Williams SCR, Mehta MA. Methylphenidate effects on prefrontal functioning during attentionalcapture and response inhibition. Biol Psychiatry. 2012;72(2):142–9.
  • Mehta MA, Goodyer IM, Sahakian BJ. Methylphenidate improves working memory and set-shifting in AD/HD: relationships to baseline memory capacity. J Child Psychol Psychiatry. 2004;45(2):293–305.
  • Mehta MA, Owen AM, Sahakian BJ, Mavaddat N, Pickard JD, Robbins TW. Methylphenidate enhances working memory by modulating discrete frontal and parietal lobe regions in the human brain. J Neurosci. 2000;20(6):RC65.
  • Devilbiss DM, Berridge CW. Low-dose methylphenidate actions on tonic and phasic locus coeruleus discharge. J Pharmacol Exp Ther. 2006;319(3):1327–35.
  • Berridge CW, Devilbiss DM, Andrzejewski ME, Arnsten AFT, Kelley AE, Schmeichel B, et al. Methylphenidate preferentially increases catecholamine neurotransmission within the prefrontal cortex at low doses that enhance cognitive function. Biol Psychiatry. 2006;60(10):1111–20.
  • Pietrzak R, Mollica C, Maruff P, Snyder P. Cognitive effects of immediate-release methylphenidate in children with attention-deficit/hyperactivity disorder. Neurosci Biobehav Rev. 2006;30(8):1225–45.
  • Rapport MD, Carlson GA, Kelly KL, Pataki C. Methylphenidate and desipramine in hospitalized children: I. separate and combined effects on cognitive function. J Am Acad Child Adolesc Psychiatry. 1993;32(2):333–42.
  • Coghill D, Banaschewski T, Zuddas A, Pelaz A, Gagliano A, Doepfner M. Long-acting methylphenidate formulations in the treatment of attention-deficit/hyperactivity disorder: a systematic review of head-to-head studies. BMC Psychiatry. 2013;13(1):237.
  • Rapport MD, Kelly KL. Psychostimulant effects on learning and cognitive function. In: Handbook of hyperactivity in children. 1993. p. 97–136.
  • Bymaster FP, Katner JS, Nelson DL, Hemrick-Luecke SK, Threlkeld PG, Heiligenstein JH, et al. Atomoxetine increases extracellular levels of norepinephrine and dopamine in prefrontal cortex of rat: a potential mechanism for efficacy in attention deficit/hyperactivity disorder. Neuropsychopharmacology. 2002;27(5):699–711.
  • Stahl SM. Neurotransmission of cognition, part 2. Selective NRIs are smart drugs: exploiting regionally selective actions on both dopamine and norepinephrine to enhance cognition. J Clin Psychiatry. 2003;64(2):110–1.
  • Simpson D, Perry CM. Atomoxetine. Paediatr Drugs. 2003;5(6):407–15
  • Ding YS, Naganawa M, Gallezot JD, Nabulsi N, Lin SF, Ropchan J, et al. Clinical doses of atomoxetine significantly occupy both norepinephrine and serotonin transports: Implications on treatment of depression and ADHD. Neuroimage. 2014;86:164–71.
  • Gallezot JD, Weinzimmer D, Nabulsi N, Lin SF, Fowles K, Sandiego C, et al. Evaluation of [(11)C]MRB for assessment of occupancy of norepinephrine transporters: Studies with atomoxetine in non-human primates. Neuroimage. 2011;56(1):268–79.
  • Wee S, Woolverton WL. Evaluation of the reinforcing effects of atomoxetine in monkeys: comparison to methylphenidate and desipramine. Drug Alcohol Depend. 2004;75(3):271–6.
  • Schwartz S, Correll CU. Efficacy and safety of atomoxetine in children and adolescents with attention-deficit/hyperactivity disorder: results from a comprehensive meta-analysis and metaregression. J Am Acad Child Adolesc Psychiatry. 2014;53(2):174–87.
  • Weiss M, Tannock R, Kratochvil C, Dunn D, Velez-Borras J, Thomason C, et al. A randomized, placebo-controlled study of once-daily atomoxetine in the school setting in children with ADHD. J Am Acad Child Adolesc Psychiatry. 2005;44(7):647–55.
  • Perwien AR, Kratochvil CJ, Faries DE, Vaughan BS, Spencer T, Brown RT. Atomoxetine treatment in children and adolescents with attention-deficit hyperactivity disorder: what are the long-term health-related quality-of-life outcomes? J Child Adolesc Psychopharmacol. 2006;16(6):713–24.
  • Donnelly C, Bangs M, Trzepacz P, Jin L, Zhang S, Witte MM, et al. Safety and tolerability of atomoxetine over 3 to 4 years in children and adolescents with ADHD. J Am Acad Child Adolesc Psychiatry. 2009;48(2):176–85.
  • Brown TE, Holdnack J, Saylor K, Adler L, Spencer T, Williams DW, et al. Effect of atomoxetine on executive function impairments in adults with ADHD. J Atten Disord. 2011;15(2):130–8.
  • Adler LA, Spencer TJ, Williams DW, Moore RJ, Michelson D. Long-term, open-label safety and efficacy of atomoxetine in adults with ADHD: final report of a 4-year study. J Atten Disord. 2008;12(3):248–53.
  • Geller D, Donnelly C, Lopez F, Rubin R, Newcorn J, Sutton V, et al. Atomoxetine treatment for pediatric patients with attention-deficit/hyperactivity disorder with comorbid anxiety disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(9):1119–27.
  • Bakken RJ, Paczkowski M, Kramer HP, Axelson AA, Williams DW, Malcolm SK, et al. Effects of atomoxetine on attention-deficit/hyperactivity disorder in clinical pediatric treatment settings: a naturalistic study. Curr Med Res Opin. 2008;24(2):449–60.
  • Gibson AP. Atomoxetine versus stimulants for treatment of attention deficit/hyperactivity disorder. Ann Pharmacother. 2006;40(6):1134–42.
  • Banaschewski T, Coghill D, Santosh P, Zuddas A, Asherson P, Buitelaar J, et al. Long-acting medications for the treatment of hyperkinetic disorders - a systematic review and European treatment guidelines. Part 2: a quantitative evaluation of long-acting medications. Z Kinder Jugendpsychiatr Psychother. 2008;36(2):97–10.
  • Yang L, Cao Q, Shuai L, Li H, Chan RCK, Wang Y. Comparative study of OROS-MPH and atomoxetine on executive function improvement in ADHD: a randomized controlled trial. Int J Neuropsychopharmacol. 2012;15(1):15–26.
  • Chamberlain SR, Müller U, Blackwell AD, Clark L, Robbins TW, Sahakian BJ. Neurochemical modulation of response inhibition and probabilistic learning in humans. Science. 2006;311(5762):861–3.
  • Chamberlain SR, Hampshire A, Müller U, Rubia K, Del Campo N, Craig K, et al. Atomoxetine modulates right inferior frontal activation during inhibitory control: a pharmacological functional magnetic resonance imaging study. Biol Psychiatry. 2009;65(7):550–5.
  • de Jong CGW, Van De Voorde S, Roeyers H, Raymaekers R, Allen AJ, Knijff S, et al. Differential effects of atomoxetine on executive functioning and lexical decision in attentiondeficit/hyperactivity disorder and reading disorder. J Child Adolesc Psychopharmacol. 2009;19(6):699–707.
  • Sumner CR, Gathercole S, Greenbaum M, Rubin R, Williams D, Hollandbeck M, et al. Atomoxetine for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children with ADHD and dyslexia. Child Adolesc Psychiatry Ment Health. 2009;3:40
  • Wilens TE, Hammerness P, Utzinger L, Schillinger M, Georgiopoulous A, Doyle RL, et al. An open study of adjunct OROS-methylphenidate in children and adolescents who are atomoxetine partial responders: I. Effectiveness. J Child Adolesc Psychopharmacol. 2009;19(5):485–92.
  • Faraone SV, Biederman J, Spencer T, Michelson D, Adler L, Reimherr F, et al. Atomoxetine and stroop task performance in adult attentiondeficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2005;15(4):664–70.
  • Gau SS, Shang C. Improvement of executive functions in boys with attention deficit hyperactivity disorder : an open-label follow-up study with once-daily atomoxetine. 2010;243–56.
  • Barton J, Mooney P, Prasad S. Atomoxetine hydrochloride and executive function in children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. 2005;15(2):147–9.
  • Yildiz O, Sismanlar SG, Memik NC, Karakaya I, Agaoglu B. Atomoxetine and methylphenidate treatment in children with ADHD: The efficacy, tolerability and effects on executive functions. Child Psychiatry Hum Dev. 2010;42(3):257–69.
  • Cubillo A, Smith AB, Barrett N, Giampietro V, Brammer MJ, Simmons A, et al. Shared and drug-specific effects of atomoxetine and methylphenidate on inhibitory brain dysfunction in medication-naive ADHD boys. Cereb Cortex. 2014;24(1):174–85.
  • Marquand AF, De Simoni S, O’Daly OG, Williams SCR, Mourão-Miranda J, Mehta MA. Pattern classification of working memory networks reveals differential effects of methylphenidate, atomoxetine, and placebo in healthy volunteers. Neuropsychopharmacology. 2011;36(6):1237–47.
Fuente de los datos: Dialnet