Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA.
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 Northwest Fourteenth Street, Suite 1455, Miami, FL 33136, USA.
Child Adolesc Psychiatr Clin N Am. 2022 Jul;31(3):469-477. doi: 10.1016/j.chc.2022.03.004. Epub 2022 May 11.
A complete and comprehensive medical and psychiatric evaluation is necessary to delineate tic symptoms from attention-deficit/hyperactivity disorder, and to prioritize the most problematic symptoms for intervention. Stimulants are the recommended first-line pharmacotherapy to treat attention-deficit/hyperactivity disorder symptoms in patients with tic disorders. Comprehensive behavioral intervention for tics is an effective behavioral therapy that is generally considered the first-line treatment of persistent tic disorders. α-Agonists can be added to stimulants if tics increase or be used as monotherapy to target attention-deficit/hyperactivity disorder and tics. Atomoxetine is also an excellent option to treat attention-deficit/hyperactivity disorder and tics.
需要进行全面、综合的医学和精神病学评估，以区分抽动症状和注意缺陷/多动障碍，并确定最需要干预的症状。对于伴有抽动障碍的注意缺陷/多动障碍患者，推荐使用兴奋剂作为一线药物治疗。针对抽动的综合行为干预是一种有效的行为疗法，通常被认为是持续性抽动障碍的一线治疗方法。如果抽动增加，可以在兴奋剂的基础上加用 α 受体激动剂，或单独使用α 受体激动剂治疗注意缺陷/多动障碍和抽动。托莫西汀也是治疗注意缺陷/多动障碍和抽动的绝佳选择。
