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ADHD 治疗的终身演变。

Lifetime evolution of ADHD treatment.

机构信息

Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.

Department of Clinical and Experimental Medicine Section of Psychiatry, University of Pisa, Pisa, Italy.

出版信息

J Neural Transm (Vienna). 2021 Jul;128(7):1085-1098. doi: 10.1007/s00702-021-02336-w. Epub 2021 May 15.

Abstract

Attention-deficit hyperactivity disorder (ADHD), has been traditionally considered a neurodevelopmental disorder affecting children and adolescents characterized by inattention, hyperactivity, disruptive behavior, and impulsivity. Although still debated, it is evident that ADHD is also present in adulthood, but this diagnosis is rarely carried out, mainly for the frequent comorbidity with other psychiatric and/or substance abuse disorders. Given the need to shed more light on the pharmacological treatment of ADHD, we performed a naturalistic review to review and comment on the available literature of ADHD treatment across the lifespan. Indeed, stimulants are endowed of a prompt efficacy and safety, whilst non-stimulants, although requiring some weeks to be fully effective, are useful when a substance abuse history is detected. In any case, the pharmacological management of ADHD appears to be still largely influenced by the individual experience of the clinicians. Further longitudinal studies with a careful and detailed characterization of participants across different phases of the lifespan are also required to provide relevant confirmations (or denials) regarding pharmacological treatments amongst the different age groups.

摘要

注意缺陷多动障碍(ADHD),传统上被认为是一种影响儿童和青少年的神经发育障碍,其特征为注意力不集中、多动、行为障碍和冲动。尽管仍存在争议,但ADHD 在成年期也确实存在,只是这种诊断很少进行,主要是因为它常与其他精神疾病和/或物质滥用障碍共病。鉴于需要更深入地了解 ADHD 的药物治疗,我们进行了一项自然主义综述,以回顾和评论 ADHD 全生命周期治疗的现有文献。事实上,兴奋剂具有快速的疗效和安全性,而非兴奋剂虽然需要数周时间才能完全有效,但在发现物质滥用史时很有用。无论如何,ADHD 的药物治疗似乎仍然在很大程度上受到临床医生个人经验的影响。还需要进一步进行纵向研究,对不同生命阶段的参与者进行仔细和详细的特征描述,以提供关于不同年龄组药物治疗的相关证实(或否认)。

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