注意力缺陷多动障碍药物的新型制剂：兴奋剂的选择与管理
Novel Formulations of ADHD Medications: Stimulant Selection and Management.
作者信息
Childress Ann C
机构信息
Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas.
出版信息
Focus (Am Psychiatr Publ). 2021 Jan;19(1):31-38. doi: 10.1176/appi.focus.20200032. Epub 2021 Jan 25.
Abstract
Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric disorder in children and adolescents in the United States. In 2016, approximately 3.8 million U.S. children ages 2 to 17 years with ADHD were being treated with medication. There are approximately 30 different amphetamine (AMPH) and methylphenidate (MPH) formulations on the market. These include immediate-release and extended-release compounds. The extended-release formulations contain various ratios of immediate-release and extended-release components, which determine the pharmacokinetic (PK) profile. For stimulants, the PK and pharmacodynamic (PD) profiles are tightly linked, and the immediate-release and extended-release percentages influence onset and duration of drug effects. Choosing the right stimulant medication for a patient depends on an understanding of the PK/PD profile, the time of day that symptoms are most impairing, the need for morning and evening symptom control and individual patient preferences.
摘要
注意力缺陷多动障碍（ADHD）是美国儿童和青少年中最常被诊断出的精神疾病。2016年，约380万年龄在2至17岁的美国ADHD儿童正在接受药物治疗。市场上大约有30种不同的苯丙胺（AMPH）和哌甲酯（MPH）制剂。这些制剂包括速释和缓释化合物。缓释制剂含有不同比例的速释和缓释成分，这决定了药代动力学（PK）特征。对于兴奋剂而言，PK和药效学（PD）特征紧密相连，速释和缓释的百分比会影响药物作用的起效时间和持续时间。为患者选择合适的兴奋剂药物取决于对PK/PD特征的了解、症状最严重的时间段、早晚症状控制的需求以及患者的个人偏好。
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