Biederman J
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Harvard School of Medicine, Boston 02114, USA.
J Clin Psychiatry. 1998;59 Suppl 7:4-16.
There is increasing scientific recognition that attention-deficit/hyperactivity disorder (ADHD), a heterogeneous disorder that carries a high risk of comorbidity, continues past childhood and adolescence into adulthood in many cases and may be underidentified in girls. The etiology of ADHD is unknown, although evidence from family studies of ADHD suggests a genetic origin for some forms of this disorder. A variety of pharmacologic agents are available in treating ADHD: stimulant medications remain the first-line treatment for noncomorbid ADHD, whereas tricyclic antidepressants and bupropion are recommended for stimulant nonresponders and patients with more than one psychiatric disorder. Complex cases of ADHD, however, may require rational use of combined pharmacotherapy.
越来越多的科学研究认识到,注意力缺陷多动障碍(ADHD)是一种具有高共病风险的异质性疾病,在许多情况下会从儿童期和青少年期持续到成年期,并且在女孩中可能未被充分识别。ADHD的病因尚不清楚,尽管ADHD家族研究的证据表明这种疾病的某些形式有遗传起源。有多种药物可用于治疗ADHD:兴奋剂药物仍然是治疗非共病ADHD的一线药物,而三环类抗抑郁药和安非他酮则推荐用于对兴奋剂无反应的患者以及患有多种精神疾病的患者。然而,ADHD的复杂病例可能需要合理使用联合药物治疗。