Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.
Midwest Research Group, St. Charles, Missouri, USA.
CNS Spectr. 2021 Jun;26(3):202-221. doi: 10.1017/S1092852919001822. Epub 2020 Feb 26.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that manifests in childhood and can persist into adolescence and adulthood. Impairments associated with ADHD can impact quality of life, social interactions, and increase the risk of morbidity and mortality; however, for many patients, effective treatment can lessen these effects. Pharmacotherapy with stimulants or nonstimulants is recommended in conjunction with psychosocial therapy for most patients. Determining the optimal pharmacotherapy can be complex, and the clinician needs to consider many factors such as the patient's age, comorbidities, and lifestyle. Furthermore, the needs of the patient with ADHD will change over time, with specific challenges to consider at each stage of life. A variety of Food and Drug Administration (FDA)-approved stimulant and nonstimulant formulations are available with different modes of delivery and durations of effect. This armamentarium of ADHD medications can be used to individualize ADHD treatment for each patient's needs. This article combines current information from the literature and the first-hand experience of the authors to provide guidance on ADHD treatment options for patients of different ages and for some of the more common comorbidities.
注意缺陷多动障碍(ADHD)是一种神经发育障碍,在儿童期表现出来,并可能持续到青少年和成年期。与 ADHD 相关的障碍会影响生活质量、社交互动,并增加发病率和死亡率的风险;然而,对于许多患者来说,有效的治疗可以减轻这些影响。大多数患者建议在心理社会治疗的基础上联合使用兴奋剂或非兴奋剂进行药物治疗。确定最佳的药物治疗可能很复杂,临床医生需要考虑许多因素,如患者的年龄、合并症和生活方式。此外,ADHD 患者的需求会随着时间的推移而变化,在生命的每个阶段都需要考虑特定的挑战。有多种获得美国食品和药物管理局(FDA)批准的兴奋剂和非兴奋剂制剂,具有不同的给药方式和作用持续时间。这些 ADHD 药物可用于根据每个患者的需求个体化 ADHD 治疗。本文结合文献中的最新信息和作者的第一手经验,为不同年龄的患者和一些更常见的合并症提供 ADHD 治疗选择的指导。