Schubiner H, Tzelepis A, Isaacson J H, Warbasse L H, Zacharek M, Musial J
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Mich, USA.
J Clin Psychiatry. 1995 Apr;56(4):146-50.
It is now recognized that attention-deficit/hyperactivity disorder (ADHD) may persist into adulthood. A number of studies have found an association between ADHD and substance abuse. This article describes three adult patients with both ADHD and substance abuse who were treated successfully with psychostimulants. A review of the relevant literature is included.
The patients were drawn from a university-based referral center for adults with ADHD. Evaluations for ADHD and substance abuse were completed. Medical therapy and follow-up were completed by the first author.
All of the patients responded to psychostimulants and have remained abstinent from alcohol and other drugs for the past 2 to 3 years.
This case series and review of the literature suggest that specific treatment for ADHD with psychostimulants is feasible in patients who also have substance abuse. Future studies should evaluate the prevalence of this "dual diagnosis" and the efficacy of differing management strategies.
目前人们认识到注意力缺陷多动障碍（ADHD）可能会持续到成年期。多项研究发现ADHD与药物滥用之间存在关联。本文描述了三名同时患有ADHD和药物滥用的成年患者，他们通过使用精神兴奋剂成功得到治疗。文中还包括了相关文献综述。
这些患者来自一所大学的成人ADHD转诊中心。完成了对ADHD和药物滥用的评估。医学治疗和随访由第一作者完成。
所有患者对精神兴奋剂均有反应，并且在过去2至3年中一直戒酒及其他药物。
该病例系列及文献综述表明，对于同时患有药物滥用的患者，使用精神兴奋剂对ADHD进行特异性治疗是可行的。未来的研究应评估这种“双重诊断”的患病率以及不同管理策略的疗效。
