Wilens Timothy E, Spencer Thomas J, Biederman Joseph
Massachusetts General Hospital, Boston, MA 02114, USA.
J Atten Disord. 2002 Mar;5(4):189-202. doi: 10.1177/108705470100500401.
Despite the increasing recognition of attention deficit hyperactivity disorder (ADHD) in adults, the use of pharmacotherapeutics remains less established.
A systematic review of the literature identified 15 studies (N = 435 subjects) of stimulants, and 22 studies of non-stimulant medications (N = 421 subjects) including antidepressants, antihypertensives, amino acids, and wake-promoting agents for the treatment of ADHD in adults.
Studies with stimulants and antidepressants demonstrated significant short-term improvement in ADHD symptoms compared to placebo in adults. Methylphenidate (MPH) and amphetamine had an immediate onset of action whereas the ADHD response to pemoline and antidepressants appeared delayed. The response to amphetamine and MPH appears to be dose-dependent. Controlled data on nicotonic and noradrenergic compounds appear promising. There was considerable variability in diagnostic criteria, dosing parameters, and response rates between the various studies.
Under controlled conditions, the aggregate literature shows that the stimulants and noradrenergic antidepressants had a clinically and statistically significant beneficial effect on treating ADHD in adults.
尽管成人注意力缺陷多动障碍（ADHD）越来越受到关注，但药物治疗的应用仍不太成熟。
一项系统的文献综述确定了15项关于兴奋剂的研究（N = 435名受试者），以及22项关于非兴奋剂药物的研究（N = 421名受试者），这些药物包括抗抑郁药、抗高血压药、氨基酸和促醒剂，用于治疗成人ADHD。
与安慰剂相比，使用兴奋剂和抗抑郁药的研究表明成人ADHD症状在短期内有显著改善。哌醋甲酯（MPH）和苯丙胺起效迅速，而匹莫林和抗抑郁药对ADHD的反应似乎延迟。对苯丙胺和MPH的反应似乎呈剂量依赖性。关于烟碱和去甲肾上腺素能化合物的对照数据看起来很有前景。各项研究之间在诊断标准、给药参数和反应率方面存在相当大的差异。
在对照条件下，综合文献表明兴奋剂和去甲肾上腺素能抗抑郁药对治疗成人ADHD具有临床和统计学上的显著有益效果。
