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成人注意缺陷多动障碍的药物治疗进展。

An update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adults.

机构信息

Clinical Research Program in Pediatric Psychopharmacology, Child Psychiatry Service, Massachusetts General Hospital, Boston, MA, USA.

出版信息

Expert Rev Neurother. 2011 Oct;11(10):1443-65. doi: 10.1586/ern.11.137.

Abstract

Adults with attention-deficit/hyperactivity disorder (ADHD) are more frequently presenting for diagnosis and treatment. Medication is considered to be appropriate among available treatments for ADHD; however, the evidence supporting the use of pharmacotherapeutics for adults with ADHD remains less established. In this article, the effectiveness and dosing parameters of the various agents investigated for adult ADHD are reviewed. In adults with ADHD, short-term improvements in symptomatology have been documented through the use of stimulants and antidepressants. Studies suggest that methylphenidate and amphetamine maintained an immediate onset of action, whereas the ADHD response to the nonstimulants appeared to be delayed. At a group level, there appears to be some, albeit not entirely consistent, dose-dependent responses to amphetamine and methylphenidate. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies was considerable, and most studies were of a relatively short duration. The aggregate literature shows that the stimulants and catecholaminergic nonstimulants investigated had a clinically significant beneficial effect on treating ADHD in adults.

摘要

患有注意缺陷多动障碍(ADHD)的成年人更频繁地寻求诊断和治疗。药物治疗被认为是 ADHD 可用治疗方法中合适的方法;然而,支持将药物治疗用于 ADHD 成人的证据仍然不太确定。本文回顾了各种用于成人 ADHD 的药物的疗效和剂量参数。在 ADHD 成人中,通过使用兴奋剂和抗抑郁药已经记录到症状短期改善。研究表明,哌甲酯和安非他命能立即起效,而非兴奋剂对 ADHD 的反应似乎延迟。在群体水平上,对于安非他命和哌甲酯,似乎存在一定程度的、但并非完全一致的剂量依赖性反应。一般来说,不同研究之间的诊断标准、剂量参数和反应率存在很大差异,并且大多数研究的持续时间相对较短。综合文献表明,研究中使用的兴奋剂和儿茶酚胺非兴奋剂对治疗成人 ADHD 具有显著的临床益处。

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