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ADHD 与青少年物质使用障碍:评估、诊断与药物治疗的相关考量。

ADHD and Substance Use Disorders in Young People: Considerations for Evaluation, Diagnosis, and Pharmacotherapy.

机构信息

Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Warren Building 628B, 55 Fruit Street, Boston, MA 02114, USA.

Division of Child and Adolescent Psychiatry, Child Psychiatry Service, Massachusetts General Hospital, 55 Fruit Street, YAW 6A, Boston, MA 02114, USA; Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA 02114, USA; Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA.

出版信息

Child Adolesc Psychiatr Clin N Am. 2022 Jul;31(3):515-530. doi: 10.1016/j.chc.2022.01.005. Epub 2022 May 11.

Abstract

Co-occurring ADHD and substance use disorder (SUD) is a common clinical presentation associated with significant impairment requiring careful evaluation, diagnosis, and treatment. Treatment with medication, along with cognitive behavioral therapy, is generally regarded as effective in addressing symptoms and impairments associated with both disorders. Options for pharmacotherapy include stimulant and nonstimulant therapies administered with careful monitoring of dosage and compliance to optimize efficacy. In high-risk groups such as college students and/or those with SUD, prescribers should address risks of stimulant misuse and diversion through patient and family education, medication monitoring, and other risk-reducing practices.

摘要

共病注意缺陷多动障碍(ADHD)和物质使用障碍(SUD)是一种常见的临床症状,会导致明显的功能损害,需要仔细评估、诊断和治疗。药物治疗联合认知行为疗法通常被认为能有效改善这两种疾病相关的症状和功能损害。药物治疗的选择包括使用兴奋剂和非兴奋剂治疗,同时要仔细监测剂量和用药依从性,以优化疗效。在高危人群(如大学生和/或有 SUD 的人群)中,医生应通过患者和家属教育、药物监测和其他降低风险的措施,解决兴奋剂滥用和转移的风险。

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