QE II Hospital, East and North Hertfordshire NHS Trust, Welwyn Garden City, UK.
Ann Gen Psychiatry. 2011 Sep 30;10:25. doi: 10.1186/1744-859X-10-25.
Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioural disorder in childhood, affecting over 5% of children worldwide. As well as the core symptoms of inattention, hyperactivity and impulsivity, patients often exhibit learning difficulties and impairment in social functioning. The frequency of referral is higher for boys than for girls (about 2:1), and girls are generally older at the time of referral.Pharmacological therapy is considered the first-line treatment for patients with severe ADHD and severe impairment. Stimulant medications are licensed in the UK for the management of ADHD in school-age children and young people, and are effective in controlling ADHD symptoms.While immediate-release preparations of methylphenidate (MPH) have proven effective in the treatment of ADHD, there are a number of problems associated with their use, most notably compliance, stigma and medication diversion. Modified release preparations are now available that overcome the need for multiple daily dosing, and which offer different MPH release profiles, thereby enabling the physician to match the medication to the patient's particular requirements.This review describes the diagnosis, referral and treatment pathways for patients with ADHD in the UK and the practical considerations when initiating pharmacological treatment. The clinical experience of treating ADHD with a modified-release MPH preparation (Equasym XL®) is illustrated with case studies.
注意缺陷多动障碍（ADHD）是儿童期最常见的神经行为障碍，全球超过 5%的儿童受其影响。除了注意力不集中、多动和冲动等核心症状外，患者还常常表现出学习困难和社交功能障碍。男孩的就诊频率高于女孩（约为 2:1），而且女孩的就诊年龄通常更大。对于严重 ADHD 和严重功能损害的患者，药物治疗被认为是一线治疗方法。在英国，兴奋剂药物被批准用于治疗学龄儿童和年轻人的 ADHD，并且在控制 ADHD 症状方面非常有效。虽然速释制剂的哌甲酯（MPH）已被证明对 ADHD 的治疗有效，但在使用过程中存在许多问题，最突出的是依从性、污名化和药物转移。现在有了控释制剂，可以避免每日多次服药，并且提供不同的 MPH 释放曲线，从而使医生能够根据患者的特定需求来匹配药物。本综述描述了英国 ADHD 患者的诊断、转诊和治疗途径，以及在开始药物治疗时需要考虑的实际问题。通过案例研究说明了使用控释 MPH 制剂（Equasym XL®）治疗 ADHD 的临床经验。
