Barkla Xanthe M, McArdle Paul A, Newbury-Birch Dorothy
Children and Young People's Service, Villa 9, Northgate Hospital, Morpeth, Northumberland, UK.
Institute of Health & Society, Newcastle University, Newcastle, UK.
BMC Psychiatry. 2015 Oct 30;15:270. doi: 10.1186/s12888-015-0657-9.
Among young people up to 18 years of age, approximately 5% have attention deficit hyperactivity disorder (ADHD), many of whom have symptoms persisting into adulthood. ADHD is associated with increased risk of co-morbid psychiatric disorders, including substance misuse. Many will be prescribed medication, namely methylphenidate, atomoxetine, dexamphetamine and lisdexamfetamine. If so, it is important to know if interactions exist and if they are potentially toxic.
Three databases (Medline, EMBASE and PsychINFO) from a 22 year period (1992 - June 2014) were searched systematically. Key search terms included alcohol, substance related disorders, methylphenidate, atomoxetine, dexamphetamine, lisdexamfetamine, and death, which identified 493 citations (344 after removal of duplicates). The eligibility of each study was assessed jointly by two investigators, leaving 20 relevant articles.
We identified only a minimal increase in side-effects when ADHD medication (therapeutic doses) was taken with alcohol. None of the reviewed studies showed severe sequelae among those who had overdosed on ADHD medication and other coingestants, including alcohol.
The numbers across all the papers studied remain too low to exclude uncommon effects. Also, studies of combined effects with novel psychoactive substances have not yet appeared in the literature. Nevertheless, no serious sequelae were identified from combining ADHD medication with alcohol/illicit substances from the pre-novel psychoactive substance era.
在18岁以下的年轻人中，约5%患有注意力缺陷多动障碍（ADHD），其中许多人的症状会持续到成年期。ADHD与包括药物滥用在内的共病精神障碍风险增加有关。许多患者会被开具药物，即哌甲酯、托莫西汀、右旋苯丙胺和赖氨酸右旋苯丙胺。如果是这样，了解是否存在相互作用以及它们是否具有潜在毒性就很重要。
系统检索了22年期间（1992年至2014年6月）的三个数据库（Medline、EMBASE和PsychINFO）。关键检索词包括酒精、物质相关障碍、哌甲酯、托莫西汀、右旋苯丙胺、赖氨酸右旋苯丙胺和死亡，共识别出493条引文（去除重复项后为344条）。由两名研究人员共同评估每项研究的合格性，最终留下20篇相关文章。
我们发现，ADHD药物（治疗剂量）与酒精一起服用时，副作用仅略有增加。在所有综述研究中，没有一项显示ADHD药物与其他共同摄入物质（包括酒精）过量服用者出现严重后遗症。
所有研究论文中的病例数仍然太少，无法排除罕见效应。此外，关于与新型精神活性物质联合作用的研究尚未见诸文献。然而，在新型精神活性物质时代之前，未发现ADHD药物与酒精/非法物质联合使用会导致严重后遗症。
