Manos Michael J
Center for Pediatric Behavioral Health, Pediatric Institute and Children's Hospital, Cleveland Clinic, Cleveland, Ohio, USA.
Medscape J Med. 2008 Jan 8;10(1):5.
The names assigned to attention-deficit/hyperactive disorder (ADHD) have changed over the years. ADHD cannot be cured, and the patient with ADHD journeys through life with a burden. Although ADHD is most commonly studied in school-aged children, it is a syndrome that spans the life cycle, through adolescence and into adulthood. Improvements in patient adherence to pharmacologic treatment, attributable to the launch of new formulations, the availability of new non-schedule II drugs, and the development of novel drugs in late-stage clinical trials, are transforming the treatment of ADHD. For example, atomoxetine is a nonstimulant treatment, and lisdexamfetamine was developed with the goal of providing an extended duration of effect with a reduced potential for abuse, overdose toxicity, and drug tampering. Known adverse effects of stimulant treatment of ADHD include appetite suppression and sleep disturbance. Other adverse effects, such as growth suppression and substance use disorder, are controversial. The US Food and Drug Administration (FDA) recently issued a public health advisory for drugs approved for the treatment of ADHD to provide more information for patients about potential risks of ADHD medications. Additional research is needed on approaches for treating ADHD in adolescents transitioning into adulthood, as are studies on the relationships between ADHD and comorbidities such as substance use disorder.
多年来，注意力缺陷多动障碍（ADHD）的命名发生了变化。ADHD无法治愈，患有ADHD的患者一生都背负着负担。尽管ADHD最常在校龄儿童中进行研究，但它是一种贯穿生命周期的综合征，从青少年期一直到成年期。由于新剂型的推出、新的非二类药物的可获得性以及后期临床试验中新型药物的研发，患者对药物治疗的依从性得到改善，正在改变ADHD的治疗方式。例如，托莫西汀是一种非兴奋剂治疗药物，而赖右苯丙胺的研发目的是提供延长的药效持续时间，同时降低滥用、过量毒性和药物篡改的可能性。ADHD兴奋剂治疗的已知不良反应包括食欲抑制和睡眠障碍。其他不良反应，如生长抑制和物质使用障碍，存在争议。美国食品药品监督管理局（FDA）最近针对获批用于治疗ADHD的药物发布了一份公共卫生咨询报告，以便为患者提供更多有关ADHD药物潜在风险的信息。对于处于向成年期过渡阶段的青少年ADHD治疗方法，以及ADHD与物质使用障碍等共病之间关系的研究，都需要进一步开展。
