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注意缺陷多动障碍药物治疗的新前沿

New frontiers in pharmacological treatment of attention-deficit hyperactivity disorder.

作者信息

Noah Ashraf A, Sedky Heba Essam

机构信息

Alexandria Clinical Research Administration, Directorate of Health Affairs, Egyptian Ministry of Health and Population, Alexandria, Egypt.

Department of Pharmacology and Experimental Therapeutics, Medical Research Institute, Alexandria University, Alexandria, Egypt.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 2025 Jun 6. doi: 10.1007/s00210-025-04328-z.

Abstract

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. This manuscript reviews the current understanding of ADHD and evaluates treatment approaches, including emerging technologies, to improve outcomes and reduce societal impact. A comprehensive review of the literature was conducted, focusing on stimulant-based therapies, non-stimulant alternatives, and novel therapeutic devices. Clinical efficacy, safety profiles, and advancements in technology-based interventions were analyzed. Stimulant medications, such as methylphenidate and amphetamines, remain the mainstay of ADHD treatment but pose risks of abuse and dependence. Non-stimulant options, including atomoxetine and extended-release α-2 agonists like guanfacine and clonidine, provide alternatives for patients who cannot tolerate stimulants. Emerging therapeutic devices, including the Monarch eTNS System and EndeavorRx, offer innovative drug-free treatment options. The prognosis for ADHD is variable, with some individuals experiencing symptom resolution while others continue to face lifelong challenges. A multidisciplinary approach that integrates pharmacotherapy, behavioral therapy, and novel technology-based interventions holds promise for improving patient outcomes and addressing the societal impact of ADHD.

摘要

注意缺陷多动障碍(ADHD)是一种神经发育障碍,其特征为注意力不集中、多动和冲动。本文综述了目前对ADHD的认识,并评估了包括新兴技术在内的治疗方法,以改善治疗效果并减少其对社会的影响。我们对文献进行了全面综述,重点关注基于兴奋剂的疗法、非兴奋剂替代疗法和新型治疗设备。分析了临床疗效、安全性概况以及基于技术的干预措施的进展。兴奋剂药物,如哌甲酯和苯丙胺,仍然是ADHD治疗的主要手段,但存在滥用和依赖的风险。非兴奋剂选择,包括托莫西汀和缓释α-2激动剂如胍法辛和可乐定,为无法耐受兴奋剂的患者提供了替代方案。新兴的治疗设备,包括Monarch eTNS系统和EndeavorRx,提供了创新的非药物治疗选择。ADHD的预后因人而异,一些人症状得到缓解,而另一些人则继续面临终身挑战。将药物治疗、行为治疗和基于新技术的干预措施相结合的多学科方法有望改善患者的治疗效果,并应对ADHD对社会的影响。

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