Adler Lenard A, Reingold Lisa S, Morrill Melinda S, Wilens Timothy E
Faculty Practice Offices, NYU School of Medicine, 530 First Avenue, New York, NY 10016, USA.
Curr Psychiatry Rep. 2006 Oct;8(5):409-15. doi: 10.1007/s11920-006-0044-9.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders of adulthood. Although clinical guidelines recommend monotherapy with stimulants or atomoxetine, combination pharmacotherapy is a common practice among clinicians. There are four main situations in which combination medications may be necessary: partial response, dose-limiting side effects, associated disorders, and comorbid diagnoses. We present data from two chart reviews that support existing research on combination pharmacotherapy. Adjunct treatment of d-methylphenidate to stimulant medications extended the duration of therapeutic effect. Adjunct treatment of mirtazapine to stimulant medications reduced associated insomnia. These data support previous research that validates the use of combination pharmacotherapy for adults with ADHD.
注意缺陷多动障碍（ADHD）是成年期最常见的神经精神疾病之一。尽管临床指南推荐使用兴奋剂或托莫西汀进行单一疗法，但联合药物治疗在临床医生中很常见。联合用药可能必要的主要有四种情况：部分反应、剂量限制性副作用、相关疾病和共病诊断。我们提供了两项病历回顾的数据，这些数据支持了现有的联合药物治疗研究。将右旋哌甲酯作为兴奋剂药物的辅助治疗可延长治疗效果的持续时间。将米氮平作为兴奋剂药物的辅助治疗可减少相关的失眠。这些数据支持了先前的研究，该研究证实了联合药物治疗对患有ADHD的成年人的有效性。
