Adult ADHD Program, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Curr Med Res Opin. 2013 Sep;29(9):1093-104. doi: 10.1185/03007995.2013.812961. Epub 2013 Jul 2.
Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological disorder with childhood onset and persistence into adolescence and adulthood.
Our literature review reports scientific publications and guidelines on the treatment of adult ADHD, with a particular focus on European countries, identified by literature searches in Medline and Embase. The final literature search was performed in July 2012, incorporating literature from 1974 to 2012. The primary research parameters were 'Europe' (including single European countries), 'ADHD', 'attention deficit disorder', 'attention deficit', 'attention disorder', and 'hyperactivity'. Secondary search parameters were 'comorbid', 'epidemiology' or 'prevalence', 'disease management', 'drug therapy', or 'therapy'. The main searches were also limited to adults and English language publications. The papers identified by this literature review were selected for inclusion by consensus of the authors based on clinical relevance.
Appropriate resources for the diagnosis and treatment of adult ADHD in Europe are scarce, and many cases go untreated, particularly because of the frequent presence of psychiatric comorbidities. Apart from atomoxetine, and an extended-release form of methylphenidate in Germany, no other medications have been approved for starting treatment in adult ADHD patients in the European Union. However, a variety of stimulant and non-stimulant medications are used off-label, and a number of studies have confirmed that these medications are well tolerated and effective in adult patients with ADHD.
Our results emphasize the need for broader access to effective treatments for adult ADHD patients in Europe.
注意缺陷多动障碍(ADHD)是一种慢性神经生物学障碍,发病于儿童期,持续至青少年期和成年期。
我们的文献综述报告了关于成人 ADHD 治疗的科学出版物和指南,特别关注欧洲国家,通过在 Medline 和 Embase 中进行文献检索确定。最终的文献搜索于 2012 年 7 月进行,纳入了 1974 年至 2012 年的文献。主要研究参数为“欧洲”(包括单一欧洲国家)、“ADHD”、“注意力缺陷障碍”、“注意力不足”、“注意力障碍”和“多动”。次要搜索参数为“共病”、“流行病学”或“流行率”、“疾病管理”、“药物治疗”或“治疗”。主要搜索还限于成人和英语出版物。通过作者共识,根据临床相关性选择纳入本文献综述中确定的论文。
欧洲用于诊断和治疗成人 ADHD 的适当资源稀缺,许多病例未得到治疗,尤其是因为经常存在精神共病。除了托莫西汀,以及德国的哌甲酯缓释剂型外,在欧盟,没有其他药物被批准用于开始治疗成人 ADHD 患者。然而,各种兴奋剂和非兴奋剂药物被超适应证使用,许多研究证实这些药物在成人 ADHD 患者中耐受良好且有效。
我们的结果强调了需要在欧洲为成人 ADHD 患者提供更广泛的有效治疗方法。