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安非他酮作为一种多巴胺能抗抑郁药治疗成人注意缺陷多动障碍的新颖性。

The Novelty of Bupropion As a Dopaminergic Antidepressant for the Treatment of Adult Attention Deficit Hyperactive Disorder.

机构信息

Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre Jalan Yaacob Latif Bandar Tun Razak 56000, Kuala Lumpur, Malaysia.

National University of Galway, Galway, Ireland.

出版信息

Curr Drug Targets. 2019;20(2):210-219. doi: 10.2174/1389450118666170511145628.

Abstract

Attention deficit hyperactive disorder (ADHD), a hyperactivity disorder prevalent among children may continue as an adulthood attention deficit. To date, treating an individual with an adult ADHD may be an arduous task as it involves numerous challenges, which include a need for high index of suspicion to diagnose this medical condition. Many psychiatric disorders masquerade as ADHD and delay the necessary assessment and proper treatment for this debilitating medical disorder. Adult ADHD is often misdiagnosed (or under diagnosed) due to the fact that this medical condition is being masked by the patients' high level of intellectual achievement. As the ADHD in adult persists, it may end-up with impairment in the personal-social-occupational function in which the management becomes a great challenge. The treatment of ADHD can be optimized by using various drugs targets agents like norepinephrine-dopamine reuptake inhibitor (NDRI), with or without psycho stimulants like methylphenidate, which is marketed as Ritalin. Bupropion, an NDRI has a novel effect on ADHD as the molecule exerts its effects by modulating the reward-pleasure mesolimbic dopaminergic system and at the same time regulates the elevating mood dimension of the noradrenergic neurotransmission. The role of Bupropion in the neural and psychopharmacological perspective treatment of ADHD was deliberated. The present review highlights the novel effects of Bupropion in ADHD treatment, together with the help of other successful bio-psycho-social measures. This may be of immense benefit to the psychiatrists for treating their patients.

摘要

注意缺陷多动障碍(ADHD),一种在儿童中普遍存在的多动障碍,可能会持续到成年期的注意力缺陷。迄今为止,治疗患有成人 ADHD 的个体可能是一项艰巨的任务,因为这涉及到许多挑战,包括需要高度怀疑来诊断这种医疗状况。许多精神障碍伪装成 ADHD,从而延迟了对这种使人衰弱的疾病进行必要的评估和适当的治疗。成人 ADHD 经常被误诊(或漏诊),因为这种医疗状况被患者高智商所掩盖。随着成人 ADHD 的持续存在,它可能会导致个人-社会-职业功能受损,从而使管理变得极具挑战性。通过使用各种药物靶点药物,如去甲肾上腺素-多巴胺再摄取抑制剂(NDRI),可以优化 ADHD 的治疗,这些药物可以与哌甲酯等精神兴奋剂联合使用,哌甲酯以利他林的形式上市。安非他酮是一种 NDRI,对 ADHD 有新的作用,因为该分子通过调节奖励-愉悦中脑边缘多巴胺能系统来发挥作用,同时调节去甲肾上腺素能神经传递的情绪升高维度。本文从神经和精神药理学的角度讨论了安非他酮在 ADHD 治疗中的作用。本综述强调了安非他酮在 ADHD 治疗中的新作用,同时还借助了其他成功的生物-心理-社会措施。这对于治疗患者的精神科医生可能会有很大的帮助。

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