Higgins E S
Department of Family Medicine, Medical University of South Carolina, Charleston 29425-0001, USA.
J Fam Pract. 1999 Jan;48(1):15-20.
Adults who identify themselves as having problems with attention and concentration will often make an office visit to request treatment with a stimulant medication, rather than an antidepressant. The uncertainty of the diagnosis and the prospect of a long-term prescription with a stimulant medication can create a dilemma for physicians.
We searched MEDLINE for any English-language studies of antidepressant or stimulant treatment of adults with attention deficits. References from relevant articles were reviewed to supplement the MEDLINE search.
Antidepressants and stimulants seem to be equally effective for adults with attention-deficit hyperactivity disorder (ADHD). Recent controlled studies suggest that desipramine (an antidepressant) may be as effective as methylphenidate (a stimulant) for improving symptoms of adult ADHD.
Although few good controlled studies exist, the available research suggests that certain antidepressants and stimulants are equally effective for adults with ADHD. Antidepressants may offer a safe first-line treatment for adults with ADHD.
那些认为自己存在注意力和专注力问题的成年人，通常会前往门诊寻求使用兴奋剂药物而非抗抑郁药进行治疗。诊断的不确定性以及使用兴奋剂药物进行长期处方的前景，可能会给医生带来两难困境。
我们在MEDLINE中检索了关于使用抗抑郁药或兴奋剂治疗成人注意力缺陷的所有英文研究。对相关文章的参考文献进行了回顾，以补充MEDLINE检索结果。
对于患有注意力缺陷多动障碍（ADHD）的成年人，抗抑郁药和兴奋剂似乎同样有效。近期的对照研究表明，去甲丙咪嗪（一种抗抑郁药）在改善成人ADHD症状方面可能与哌甲酯（一种兴奋剂）同样有效。
尽管几乎没有高质量的对照研究，但现有研究表明，某些抗抑郁药和兴奋剂对患有ADHD的成年人同样有效。抗抑郁药可能为患有ADHD的成年人提供一种安全的一线治疗方法。
