Lie N
Tidsskr Nor Laegeforen. 1998 Nov 10;118(27):4227-9.
As early as in 1979, abuse was observed when adults with MBD were treated with psychostimulants. In a study from 1981, five patients (19%) had been stimulated or excited. It was concluded that there was no reason to believe that adults with MBD were immune from stimulant abuse problems. In subsequent studies, it has been the rule to exclude patients who abuse alcohol or drugs. Obviously, there has been agreement that treatment implies a considerable risk of abuse of stimulants. However, nobody has systematically studied the frequency of psychostimulant abuse in subjects with AD/HD with and without abuse of alcohol and drugs, neither during the study nor at follow-up. There has been some attempts at using pemoline, a stimulant which cannot be abused. However, the mental and physical complications have been severe. Some preliminary studies indicate that stimulants can be used to treat alcoholics and substance abusers with concurrent AD/HD. Before such treatment can be recommended, the observations should be confirmed in controlled studies with representative materials, and the patients should be followed over a long period of time. It seems that stimulants are not an appropriate treatment for subjects with psychopathic personality and antisocial behaviour.
早在1979年，人们就观察到患有轻微脑功能障碍（MBD）的成年人在使用精神兴奋剂治疗时会出现滥用情况。在一项1981年的研究中，有5名患者（19%）受到了刺激或变得兴奋。得出的结论是，没有理由认为患有MBD的成年人不会出现兴奋剂滥用问题。在随后的研究中，通常会排除那些酗酒或滥用药物的患者。显然，人们已经达成共识，即治疗意味着存在相当大的兴奋剂滥用风险。然而，无论是在研究期间还是随访期间，都没有人系统地研究过患有注意缺陷多动障碍（AD/HD）且有或没有酗酒及药物滥用问题的患者中精神兴奋剂滥用的频率。曾有一些使用匹莫林（一种不会被滥用的兴奋剂）的尝试。然而，其精神和身体并发症很严重。一些初步研究表明，兴奋剂可用于治疗同时患有AD/HD的酗酒者和药物滥用者。在推荐这种治疗方法之前，这些观察结果应在有代表性样本的对照研究中得到证实，并且应对患者进行长期随访。看来兴奋剂对患有精神病态人格和反社会行为的患者不是一种合适的治疗方法。
