Wilens Timothy E, Gignac Martin, Swezey Allison, Monuteaux Michael C, Biederman Joseph
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
J Am Acad Child Adolesc Psychiatry. 2006 Apr;45(4):408-14. doi: 10.1097/01.chi.0000199027.68828.b3.
Little is known about the risks and characteristics of attention-deficit/hyperactivity disorder (ADHD) patients who misuse or divert their stimulant medications. As part of a 10-year longitudinal study of youths with ADHD, the authors evaluated medication diversion or misuse at the last follow-up period.
Structured psychiatric interviews for diagnosis and a self-report questionnaire regarding medication use in medicated subjects with ADHD compared with controls without ADHD receiving psychotropics for non-ADHD treatment were employed.
Of 98 subjects receiving psychotropic medications (mean age of 20.8 +/- 5 years), 55 (56%) were ADHD subjects and 43 (44%) were controls receiving medications for other purposes. The authors found that 11% of the ADHD group reported selling their medications compared with no subjects in the control group (z = 0.00, p <.05). An additional 22% of the ADHD group reported misusing their medications compared with 5% of the control subjects (z = 1.7 p =.09) and that those with conduct or substance use disorders accounted for the misuse and diversion. A minority of subjects reported escalating their doses and concomitant use with alcohol and drugs.
The data indicate that the majority of ADHD individuals, particularly those without conduct or substance use disorders, use their medications appropriately. The authors' findings also highlight the need to monitor medication use in ADHD individuals with conduct and/or substance use disorders and to carefully select agents with a low likelihood of diversion or misuse in this group.
对于滥用或挪用兴奋剂药物的注意力缺陷多动障碍(ADHD)患者的风险及特征,人们了解甚少。作为一项针对ADHD青少年的10年纵向研究的一部分,作者在最后随访期评估了药物挪用或滥用情况。
采用结构化精神科访谈进行诊断,并使用一份关于ADHD用药受试者用药情况的自我报告问卷,与未患ADHD但接受非ADHD治疗的精神药物的对照组进行比较。
在98名接受精神药物治疗的受试者(平均年龄20.8±5岁)中,55名(56%)为ADHD受试者,43名(44%)为因其他目的接受药物治疗的对照组。作者发现,ADHD组中有11%的人报告出售过他们的药物,而对照组中无人报告此事(z = 0.00,p <.05)。ADHD组中另有22%的人报告滥用过他们的药物,而对照组中这一比例为5%(z = 1.7,p =.09),且有品行或物质使用障碍的人存在滥用和挪用药物的情况。少数受试者报告增加了用药剂量,并同时饮酒和吸毒。
数据表明,大多数ADHD患者,尤其是那些没有品行或物质使用障碍的患者,能够正确使用药物。作者的研究结果还强调,需要对患有品行和/或物质使用障碍的ADHD患者的用药情况进行监测,并在此类人群中谨慎选择挪用或滥用可能性较低的药物。