Callovini Tommaso, Janiri Delfina, Segatori Daniele, Mastroeni Giulia, Kotzalidis Georgios D, Di Nicola Marco, Sani Gabriele
Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Department of Psychiatry, Section of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Pharmaceuticals (Basel). 2024 Aug 16;17(8):1076. doi: 10.3390/ph17081076.
The literature emphasizes the importance of addressing the misuse of ADHD medications as a potential significant healthcare issue within the general population. Nevertheless, there are no systematic reviews that specifically examine whether the misuse of psychostimulant medication among clinical populations diagnosed with ADHD who are undergoing prescribed stimulant therapy is a rational concern or a false myth. This systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. We searched PubMed databases for articles indexed up to 12th July 2023, without language restrictions. Our systematic search generated 996 unique articles. After a full-text revision, 13 studies met the eligibility criteria and were included in the systematic review. In the 50% of the study on the adult population, the reported prevalence of stimulant misuse was 0%. In other studies, the range of stimulant misuse rates varied from 2% to 29%, with no available data specifically focusing on the youth population. It has been noted that misuse of prescribed stimulant treatment is linked with particular subject characteristics, such as older age, prior or more frequent use of ADHD medication, use of short-acting medication, and a history of alcohol/substance misuse diagnosis. Despite certain limitations, our study highlights that while a significant proportion of individuals undergoing psychostimulant treatment for ADHD follow their prescribed medication regimens without resorting to misuse behaviors, there is variability in adherence, with occurrences of misuse behaviors. The misuse of prescribed ADHD treatment appears to be associated with distinct subject characteristics, underscoring the importance for tailored interventions addressing the specific requirements of these individuals to attain optimal treatment outcomes while mitigating misuse risks.
文献强调了应对多动症药物滥用问题的重要性，这是普通人群中一个潜在的重大医疗保健问题。然而，目前尚无系统综述专门研究在接受规定的兴奋剂治疗的多动症临床患者中，精神兴奋剂药物滥用是合理担忧还是无稽之谈。本系统综述是根据系统评价和Meta分析的首选报告项目（PRISMA）2020声明进行的。我们在PubMed数据库中搜索截至2023年7月12日索引的文章，无语言限制。我们的系统检索共生成996篇独特文章。经过全文修订，13项研究符合纳入标准并被纳入系统综述。在针对成年人群的50%的研究中，报告的兴奋剂滥用患病率为0%。在其他研究中，兴奋剂滥用率范围从2%到29%不等，没有专门针对青年人群的可用数据。已经注意到，规定的兴奋剂治疗滥用与特定的个体特征有关，如年龄较大、既往或更频繁使用多动症药物、使用短效药物以及有酒精/物质滥用诊断史。尽管存在一定局限性，但我们的研究强调，虽然相当一部分接受多动症精神兴奋剂治疗的个体遵循规定的用药方案，未出现滥用行为，但依从性存在差异，存在滥用行为。规定的多动症治疗滥用似乎与不同的个体特征有关，这凸显了针对这些个体的特定需求进行量身定制的干预措施的重要性，以实现最佳治疗效果，同时降低滥用风险。
