Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK.
Faculty of Environmental and Life Sciences, Center for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK.
Curr Top Behav Neurosci. 2022;57:19-50. doi: 10.1007/7854_2022_330.
Attention-Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition associated with impaired function and increased risk of poor outcomes in children, young people and adults with the condition. Currently approved pharmacological treatments for ADHD include a range of stimulant (methylphenidate, amphetamine) and nonstimulant (atomoxetine, guanfacine, clonidine) medications. All have been shown to be effective in treating the symptoms of ADHD and improving other functional outcomes including quality of life, academic performance, rates of accidents and injuries, and do not appear to be associated with significant adverse outcomes or side effects. In this chapter, we review medications for ADHD by summarising the mechanisms of action of each of the two main classes of compounds (stimulants and nonstimulants), the formulations of the most commonly prescribed medications within each class, their efficacy in treating ADHD symptoms and other outcomes, and other factors that influence treatment decisions including side effects and tolerability, comorbidities and medical history. We conclude with a summary of the treatment decisions made by clinicians and suggest some next steps for research. Further research is needed to understand the mechanisms of action of these medications and how exactly they improve symptoms, and to examine their effects on commonly occurring comorbidities.
注意缺陷多动障碍（ADHD）是一种常见的神经发育障碍，与儿童、青少年和成人的功能受损以及预后不良风险增加有关。目前批准用于治疗 ADHD 的药理学方法包括一系列兴奋剂（哌甲酯、安非他命）和非兴奋剂（托莫西汀、胍法辛、可乐定）药物。所有这些药物都已被证明能有效治疗 ADHD 的症状，并改善其他功能结果，包括生活质量、学业成绩、事故和伤害发生率，且似乎与重大不良结果或副作用无关。在这一章中，我们通过总结每类（兴奋剂和非兴奋剂）两种主要化合物的作用机制、每种类别中最常开处方的药物的制剂、它们治疗 ADHD 症状和其他结果的疗效以及影响治疗决策的其他因素（包括副作用和耐受性、合并症和病史），来综述 ADHD 的药物治疗。最后，我们总结了临床医生的治疗决策，并提出了一些下一步的研究建议。需要进一步的研究来了解这些药物的作用机制以及它们如何确切地改善症状，并研究它们对常见合并症的影响。
