儿童注意力缺陷与多动障碍的药物治疗

注意力缺陷与多动障碍(ADHD)在儿童和青少年中有较高的发病率,然而在国内可能还有许多医生对其的了解还不全面。这篇译自国际知名期刊的文章将全面介绍ADHD的最新药物治疗情况,相信阅读完之后可以使您轻松掌握这一疾病的治疗方案。     

注意力缺陷多动障碍的药物治疗研究进展

目的介绍近年来治疗注意力缺陷多动障碍的药物研究进展。方法综述常用的注意力缺陷多动障碍的治疗药物及其临床应用。结果与结论注意力缺陷多动障碍的治疗药物各有优缺点,中西药物合理配合使用,能使患者获得更为高效、安全的治疗效果。     

注意力缺陷多动障碍的药物治疗研究进展

目的 介绍近年来治疗注意力缺陷多动障碍的药物研究进展。方法 综述常用的注意力缺陷多动障碍的治疗药物及其临床应用。 结果与结论 注意力缺陷多动障碍的治疗药物各有优缺点,中西药物合理配合使用,能使患者获得更为高效、安全的治疗效果。     

注意力缺陷多动障碍的中医治疗综述

从中医辨证论治、单方验方及针灸推拿3个方面就注意力缺陷障碍多动障碍(ADHD)的近年中医药研究现状进行综述,以拓宽中医对本病的治疗思路,希望能够促进中医药今后对本病的进一步研究.     

FDA药品安全和风险管理咨询委员会建议在哌甲酯类ADHD治疗药中加入黑框警告

日前，FDA药品安全和风险管理咨询委员会向FDA提出建议：应该在治疗注意力缺陷多动障碍（ADHD）的哌甲酯（Methylphemdate）类和其他精神兴奋剂的药品说明书中加入黑框警告，因为这类药品可能会增加死亡以及身体和精神伤害的风险。     

注意力缺陷多动障碍治疗药物的研究进展

注意力缺陷多动障碍是儿童期常见的一类心理障碍,影响患儿生活,而且容易导致患儿持久的学习困难,行为问题和自尊心低下。目前临床上主要有中枢兴奋剂如哌甲酯等和非中枢兴奋剂如托莫西汀等治疗药物,多数患儿在使用药物后多动行为或认知功能改善,但药量不易掌控及药物具有不良反应及停药反弹现象。本文对注意力缺陷多动障碍治疗药物做如下综述,旨在为进一步探索注意力缺陷多动障碍的药物治疗提供参考。     

注意力缺陷多动障碍患儿的临床治疗效果观察

目的：探讨注意力缺陷多动障碍(ADHD)患儿的最佳治疗方法。方法：近3年来在我院心理门诊治疗的ADHD儿童69例，按照不同的治疗方法自然分成3组，分别统计治疗后1，3，6个月的有效丰。结果：利它林治疗ADHD1，3，6个月的有效率(90.5％、88．9％，83.3％)优于静灵组和非药物组。同时还观察到药物治疗的远期疗效会逐渐减弱。心理行为矫正也是治疗ADHD的重要手段。结论：尽管各种治疗均有效果，但多动症治疗仍以综合措施为佳。     

儿童注意缺陷多动障碍(ADHD)治疗探讨

注意缺陷障碍 (ADHD)是儿童期较为常见的行为障碍 ,以与年龄不相称的注意力不集中、易冲动及活动过度为核心症状 ,同时可以合并多种心理病理表现 ,如品行障碍、对抗障碍、情绪障碍、学习障碍。本病从学龄前到学龄期影响儿童 ,甚至可以从青少年期持续到成年人。为了更好的改善ADHD对儿童身心健康的影响 ,探明行之有效的治疗方法日益显得重要 ,而传统经典的用药是以哌甲酯(利他林 )为代表的中枢兴奋剂 ,它起效快而明显 ,但由于作用短暂且副作用大等而使其应用受到了限制[1] 。1　对象与方法1 1　对象　①纳入标准 :1999年元月～ 2 0 0 0年…     

利他林治疗注意力缺陷多动障碍10例分析

2002～2003年5月我们应用利他林治疗注意缺陷多动障碍10例，现报道如下：     

关注成人的注意力缺陷与多动障碍

注意力缺陷与多动障碍(ADHD)曾一度被认为是一种儿童疾病。近年来,人们对成人ADHD的认识逐步完善和加深,并意识到成人ADHD是一种发病率较高且损害严重的疾病。随着新一代长效中枢兴奋剂的不断上市,对该病的正确识别显得尤为紧迫。本文将对成人ADHD的历史沿革、流行病学、疾病相关损害、诊断以及治疗作全面介绍。     

Dexmethylphenidate for attention deficit hyperactivity disorder

Background: Dexmethylphenidate is a single-isomer stimulant medication approved for the treatment of attention deficit hyperactivity disorder (ADHD). Single-isomer drugs have the potential for decreased undesired effects and improved therapeutic efficacy. Stimulant medications have been the mainstay treatments for ADHD for fifty years, and ability to reduce their adverse effects would be useful in promoting patient compliance with treatment. Objective: To review the literature on the safety and efficacy of dexmethylphenidate. Methods: MedLine, PubMed search of dexmethylphenidate research. Results/conclusions: Dexmethylphenidate is a safe and effective treatment for ADHD. Its overall safety and tolerability profile is similar to other members of the psychostimulant class.     

InforMatrix for attention deficit hyperactivity disorder

The purpose of this review is to facilitate discussion on drug selection for the treatment of ADHD by using only clinically relevant selection criteria and providing an up-to-date overview. The InforMatrix method was used to select drugs to treat attention deficit hyperactivity disorder (ADHD). The following selection criteria were applied: clinical efficacy, safety, tolerability, ease of use, applicability, and cost. The drugs approved for ADHD in the Netherlands were included in the analysis, namely: atomoxetine, immediate-release methylphenidate, and various formulations of slow-release methylphenidate (Concerta, Equasym and Medikinet). Most studies are of limited quality, duration, and size. In one study, Concerta was more effective than atomoxetine. Although no relevant differences were seen in other comparative studies, the clinical experience with atomoxetine is still limited and unexpected toxicity cannot be excluded; few studies have been published with Equasym and Medikinet. No major differences were seen in general tolerability between the drugs. The ease of use of immediate-release methylphenidate is less than for the other drugs. The acquisition cost of immediate-release methylphenidate is considerably lower than that of the slow-release formulations. Atomoxetine is the most expensive drug. The InforMatrix program is available in an interactive format. It enables the user to judge both the importance of the selection criteria and the properties of each therapeutic option per criterion on the basis of his or her own personal expertise and/or the present document.     

AOD use and attention deficit/hyperactivity disorder

Children with attention deficit/hyperactivity disorder (ADHD) often continue to exhibit significant impairment in academic, occupational, and social functioning throughout adulthood. In addition, children with ADHD are at increased risk for developing alcoholism and other drug addictions, especially if alcoholism or ADHD exists in other family members. Alcohol and other drug (AOD) abuse may develop earlier in life (i.e., in midadolescence) when ADHD is accompanied by certain behavioral or mood disorders. The nature of the link between ADHD and AOD use disorder is unknown, although the association may be mediated by the co-occurring disorders just mentioned. In addition, ADHD-related AOD abuse may develop initially as an attempt to alleviate symptoms of mental distress associated with chronic failure, feelings of inadequacy, and conflict with parents and peers. Therapeutic intervention should incorporate both addiction and mental health treatment, including appropriate use of psychiatric medications.     

Inositol may worsin attention deficit disorder with hyperactivity

Antidepressant drugs have been reported to improve ADDH symtomatology. Myoinositol is a simple isomer of glucose and is the precursor of the phosphatidylinositol second messenger system in brain. Both α₁-adrenergic and 5HT₂ receptors activate this second messenger system. Recently, we found inositol to be effective in depression. Therefore we decided to evaluate the effects of oral inositol in children with ADDH in a double-blind, cross-over, placebo-controlled manner. Eleven children, mean age 8.9 ± 3.6 years with a mean illness duration of 4.5 ± 2.8 years were enrolled in an 8-week trial. Inositol or dextrose (placebo) was dispensed in powder form at a dose of 200 mg/kg aggravation of the syndrome with myo-inositol as compared to placebo.     

儿童注意缺陷、多动障碍的药物治疗

注意缺陷、多动障碍 (ADHD)是儿童期最为常见的一种心理行为疾病 ,药物治疗是ADHD主要的治疗方法之一。中枢兴奋药是治疗ADHD最常用的药物 ,作用快、疗效好 ,且不良反应较少。可乐定和抗抑郁剂也有较好的治疗效果 ,可乐定主要适用于伴抽动或情绪异常的ADHD病儿 ,而抗抑郁剂多用于伴抑郁或焦虑的ADHD病儿 ,但不良反应较明显。本文还介绍了近年来出现的一些治疗AD HD的新药     

Genome-wide analysis of emotional lability in adult attention deficit hyperactivity disorder (ADHD)

Emotional lability is strongly associated with Attention Deficit Hyperactivity Disorder (ADHD), represents a major source of impairment and predicts poor clinical outcome in ADHD. Given that no specific genes with a role in the co-occurrence of both conditions have been described, we conducted a GWAS of emotional lability in 563 adults with ADHD. Despite not reaching genome-wide significance, the results highlighted genes related with neurotransmission, cognitive function and a wide range of psychiatric disorders that have emotional lability as common clinical feature. By constructing polygenic risk scores on mood instability in the UK Biobank sample and assessing their association with emotional lability in our clinical dataset, we found suggestive evidence of common genetic variation contributing to emotional lability in general population and in clinically diagnosed ADHD. Although not conclusive, these tentative results are in agreement with previous studies that suggest emotion dysregulation as a transdiagnostic construct and highlight the need for further investigation to disentangle the genetic basis of mood instability in ADHD and co-occurring psychiatric disorders.     

New developments in psychopharmacology of attention deficit hyperactivity disorder

Stimulants have been the mainstay of the psychopharmacological treatment of attention deficit hyperactivity disorder (ADHD) for over 60 years. In the last 5 years, there have been a number of important developments in terms of potential new treatments for ADHD. Since stimulants have such a short half-life, considerable research has focused on the development of new delivery systems that will allow once-a-day dosing. New formulations of both amphetamine (AMP) and methylphenidate (MPH) have appeared which differ in terms of their optical isomers from the commonly used compounds. A wide variety of compounds are currently in development as therapeutic agents for ADHD. Some, like the stimulants, primarily impact the noradrenergic and dopaminergic neurotransmitter systems, while others have novel effects on the cholinergic, histaminergic and peptidergic systems. Advances in the pharmacogenetics of ADHD may lead to the development of yet more compounds in the near future.     

Atomoxetine--treatment of attention deficit hyperactivity disorder: beyond stimulants

Among the pharmacotherapeutic interventions for attention deficit hyperactivity disorder (ADHD), psychostimulants have been the drugs of choice for many years. However, some patients do not adequately respond to or cannot tolerate stimulant treatment. Among nonstimulants for ADHD, the most extensively studied and the only one approved for use in the United States is the norepinephrine reuptake inhibitor atomoxetine. This paper reviews atomoxetine's chemistry and putative mechanism of action, as well as its clinical pharmacokinetics, metabolism, and efficacy and safety in acute clinical trials. (c) 2004 Prous Science. All rights reserved.     

Analysis of neurosteroid levels in attention deficit hyperactivity disorder

Neurosteroids are important neuroactive substrates with demonstrated involvement in several neurophysiological and disease processes. Attention deficit hyperactivity disorder (ADHD) has been associated with dysregulation of the catecholaminergic and serotonergic systems, however its relationship to irregularities or changes in neurosteroid levels remains unknown. We examined the relationship between blood levels of dehydroepiandrosterone (DHEA), its principal precursor pregnenolone and its principal metabolite dehydroepiandrosterone sulphate (DHEAS) in 29 young male subjects aged 7-15 years with DSM-IV criteria of ADHD. Subjects were evaluated by a specially designed scale, following which patients were divided into two groups according to severity of symptomatology. Results indicated significant inverse correlations between clinical symptomatology and levels of DHEA and pregnenolone in the total group. These inverse correlations were particularly evident in the less severe group of subjects. Levels of DHEA and DHEAS were inversely correlated with the hyperactivity subscale. Furthermore, using median blood levels as a cut-off indicator, higher blood levels of DHEA and DHEAS were associated with fewer ADHD symptoms, in particular hyperactivity symptomatology. Our findings suggest a possible protective effect of various neurosteroids on the expression of ADHD symptomatology.