Briars Leslie, Todd Timothy
Department of Pharmacy Practice, The University of Illinois at Chicago College of Pharmacy, Chicago, Illinois.
Department of Pharmacy Practice, Midwestern University, Downers Grove, Illinois.
J Pediatr Pharmacol Ther. 2016 May-Jun;21(3):192-206. doi: 10.5863/1551-6776-21.3.192.
Attention-deficit/hyperactivity disorder (ADHD) is a common psychological diagnosis in children. This disorder impacts children and adolescents in all areas of life, including academic performance, extracurricular activities, and social interactions. ADHD can continue into adulthood where unemployment and substance abuse has been described. Although behavioral therapy is recommended for all patients with ADHD, medication management typically is initiated soon after diagnosis. Psychostimulants remain the primary medication of choice. This review focuses on the clinical use of psychostimulant medication in children and adolescents. The pharmacodynamic and pharmacokinetic differences between the newest long-acting formulations as well as commonly encountered adverse drug reactions, with suggested management strategies, will be highlighted. Non-stimulant therapy with atomoxetine or alpha2-adrenergic agonists is also reviewed. These agents may be warranted for patients who cannot tolerate psychostimulant therapy or have a comorbid condition. Finally, the 8-year multimodal treatment study results are also discussed.
注意力缺陷多动障碍(ADHD)是儿童中常见的心理诊断疾病。这种疾病在生活的各个方面都会影响儿童和青少年,包括学业成绩、课外活动及社交互动。ADHD可持续至成年期,成年期患者存在失业及药物滥用的情况。尽管建议对所有ADHD患者进行行为治疗,但药物管理通常在诊断后不久就开始。精神兴奋剂仍然是主要的首选药物。本综述重点关注精神兴奋剂药物在儿童和青少年中的临床应用。将突出最新长效制剂之间的药效学和药代动力学差异以及常见的药物不良反应,并提出相应的管理策略。还将对使用托莫西汀或α2-肾上腺素能激动剂的非兴奋剂治疗进行综述。对于无法耐受精神兴奋剂治疗或患有合并症的患者,这些药物可能是必要的。最后,还将讨论为期8年的多模式治疗研究结果。