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有成瘾史的成人注意力缺陷多动障碍的整体管理:强调低成瘾风险的心理药物治疗。

Holistic Management of Adult ADHD with a History of Addiction: Emphasis on Low-Addiction-Risk Psychopharmacotherapy.

作者信息

Żełabowski Kacper, Petrov Wiktor, Ślebioda Dawid, Rusinek Malwina, Biedka Kamil, Błaszczyk Katarzyna, Wesołowski Michał, Wojtysiak Kacper, Sroka Mateusz, Ratka Zuzanna, Ilski Ignacy, Chłopaś-Konowałek Agnieszka

机构信息

Scientific Society for Psychopharmacology, Department of Forensic Medicine, Wroclaw Medical University, 4 J. Mikulicza-Radeckiego Street, 50345 Wroclaw, Poland.

Department of Physiology and Pathophysiology, Division of Pathophysiology, Wroclaw Medical University, Chalubinskiego 10, 50368 Wroclaw, Poland.

出版信息

J Clin Med. 2025 Sep 14;14(18):6470. doi: 10.3390/jcm14186470.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder generally associated with pediatric patients and in lesser extent with adults. Patients diagnosed with ADHD have a higher likelihood of developing addiction. Consequently, a disorder that frequently co-occurs with ADHD is Substance Use Disorder (SUD). The pharmaceuticals prescribed in the treatment of ADHD are predominantly stimulants, such as methylphenidate and amphetamines, which possess a high addiction potential. The objective of this study is to examine the risk of developing substance dependence during stimulant treatment in individuals with ADHD who have a natural predisposition to addiction, with particular emphasis on adult patients with a history of SUD. Our literature review was conducted using research papers from PubMed, Google Scholar, Embase, ProQuest and ScienceDirect. The main results from our review are as follows: (i) the majority of studies indicate that the administration of stimulants in the treatment of ADHD does not increase the risk of developing Substance Use Disorder; (ii) stimulants may also be used in the treatment of SUD; (iii) while pharmacotherapy is a crucial part of ADHD treatment, a holistic approach comprising pharmacological and non-pharmacological therapy is most effective; (iv) holistic management of ADHD is necessary to improve patients' quality of life to the greatest extent possible.

摘要

注意缺陷多动障碍(ADHD)是一种神经发育障碍,通常与儿科患者相关,在较小程度上也与成人有关。被诊断患有ADHD的患者成瘾的可能性更高。因此,一种经常与ADHD同时出现的疾病是物质使用障碍(SUD)。治疗ADHD所开的药物主要是兴奋剂,如哌甲酯和苯丙胺类药物,它们具有很高的成瘾潜力。本研究的目的是调查在有自然成瘾倾向的ADHD患者接受兴奋剂治疗期间发生物质依赖的风险,特别关注有SUD病史的成年患者。我们的文献综述使用了来自PubMed、谷歌学术、Embase、ProQuest和科学Direct的研究论文。我们综述的主要结果如下:( i)大多数研究表明, 治疗ADHD使用兴奋剂不会增加发生物质使用障碍的风险;( i i)兴奋剂也可用于治疗SUD;

( i i i)虽然药物治疗是ADHD治疗的关键部分,但包括药物和非药物治疗的整体方法最有效;( i v)对ADHD进行整体管理对于最大程度提高患者生活质量是必要的。

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