Dr. Kiran C. Patel College of Osteopathic Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Fort Lauderdale, Florida, USA.
Dr. Kiran C. Patel College of Allopathic Medicine, Health Profession Division, Nova Southeastern University, Fort Lauderdale, Florida, USA.
Psychopharmacology (Berl). 2024 Nov;241(11):2191-2203. doi: 10.1007/s00213-024-06686-7. Epub 2024 Sep 20.
The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) classifies attention deficit hyperactivity disorder (ADHD) as a neurodevelopmental disorder that interferes with human functioning and development. As the clinical presentation of ADHD involves a deficiency in executive function, neurocognitive deficits involving distinctive neuropathological changes must be present for clinical diagnosis.
The vesicular monoamine transporter (VMAT), specifically VMAT-2, plays a role in ADHD pathogenesis. In addition, experimental data show that the stimulants (amphetamines and methylphenidate) are first-line treatments for the condition because of their extensive interaction with VMAT-2. The interactions of peptides, bupropion, and nutritional supplements with VMAT-2 receptors have been researched, but more evidence is needed to elucidate their pharmacodynamic properties. Therefore, this literature review evaluated the current pharmacological treatment modalities, peptides, and nutritional supplements for ADHD that target the VMAT-2 system.
METHODS, RESULTS, AND CONCLUSIONS: We obtained relevant studies from several platforms, including the National Center for Biotechnology, Clinical Key, Access Medicine, and PubMed. From the results of these studies, we observed that stimulants interact highly with the VMAT-2 transporter, with omega-3 fatty acids, peptides, and bupropion exerting some modulatory activity on VMAT-2. These agents should be considered for the future treatment of ADHD, although clinical-level research involving human participants is necessary.
《精神疾病诊断与统计手册（第五版）》将注意缺陷多动障碍（ADHD）归类为一种神经发育障碍，会干扰人类的功能和发育。由于 ADHD 的临床表现涉及执行功能缺陷，因此必须存在涉及独特神经病理学变化的神经认知缺陷，才能进行临床诊断。
囊泡单胺转运体（VMAT），特别是 VMAT-2，在 ADHD 的发病机制中发挥作用。此外，实验数据表明，兴奋剂（安非他命和哌甲酯）是该病症的一线治疗药物，因为它们与 VMAT-2 广泛相互作用。已经研究了肽、安非他酮和营养补充剂与 VMAT-2 受体的相互作用，但需要更多证据来阐明它们的药效学特性。因此，本文献综述评估了针对 VMAT-2 系统的 ADHD 的当前药理学治疗方式、肽和营养补充剂。
方法、结果和结论：我们从多个平台（包括国家生物技术信息中心、临床关键、Access Medicine 和 PubMed）获取了相关研究。从这些研究的结果中，我们观察到兴奋剂与 VMAT-2 转运体高度相互作用，而欧米伽-3 脂肪酸、肽和安非他酮对 VMAT-2 发挥了一些调节作用。尽管需要涉及人类参与者的临床水平研究，但这些药物应被视为未来 ADHD 的治疗选择。
