Biederman J, Spencer T
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
Eur Child Adolesc Psychiatry. 2000;9 Suppl 1:I51-9. doi: 10.1007/s007870070019.
We reviewed the literature of medication trials in ADHD to evaluate the scope of the available non-stimulant treatments. A variety of compounds with a common noradrenergic/ dopaminergic activity have shown documented anti-ADHD activity. There is a substantial body of literature documenting the efficacy of tricyclic antidepressants on ADHD in over 1,000 subjects. In addition, the atypical antidepressant bupropion and the novel noradrenergic specific antidepressant tomoxetine have also been documented to be effective in the treatment of ADHD in controlled clinical trials. Despite wide use, the scientific base supporting the efficacy of alpha-2, noradrenergic agonists continues to be limited. Several lines of evidence provide preliminary support for the potential benefits of cholinergic cognitive enhancing drugs in such as anticholinesterase inhibitors (tacrine, donepezil) as well as novel nicotinic analogues (ABT-418). Despite these promising results, more research is needed on alternative pharmacologic treatments for the treatment of ADHD.
我们回顾了注意力缺陷多动障碍（ADHD）药物试验的文献，以评估现有非兴奋剂治疗的范围。多种具有共同去甲肾上腺素能/多巴胺能活性的化合物已显示出有记录的抗ADHD活性。有大量文献记录了三环类抗抑郁药对1000多名受试者ADHD的疗效。此外，非典型抗抑郁药安非他酮和新型去甲肾上腺素能特异性抗抑郁药托莫西汀在对照临床试验中也被证明对ADHD治疗有效。尽管α-2去甲肾上腺素能激动剂被广泛使用，但其疗效的科学依据仍然有限。几条证据线为胆碱能认知增强药物的潜在益处提供了初步支持，如抗胆碱酯酶抑制剂（他克林、多奈哌齐）以及新型烟碱类似物（ABT-418）。尽管有这些令人鼓舞的结果，但仍需要对ADHD的替代药物治疗进行更多研究。
