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成人注意力缺乏多动障碍的药物治疗

Author
David Brent, MD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD
Translators
钱昀, 副主任医师

引言

注意力缺乏多动障碍(attention deficit hyperactivity disorder, ADHD)过去曾被认为主要是一种儿科疾病。然而，现有数据表明，30%-70%的ADHD患儿在成人期会继续表现出症状[1-4]。

兴奋剂和某些抗抑郁药是治疗ADHD成人患者最常用的药物，但相较于儿童，其在成人中的有效率可能更低。认知行为治疗(cognitive behavioral therapy, CBT)与药物联用时已显示出有效性。

本专题将讨论针对成人ADHD的药物治疗。成人ADHD的流行病学、发病机制、临床表现、评估和诊断将单独讨论。成人ADHD的心理治疗将单独讨论。儿童ADHD也将单独讨论。 (参见“成人注意缺陷多动障碍：流行病学、发病机制、临床特征、病程、评估和诊断”和“成人注意缺陷与多动障碍的心理治疗”和“儿童和青少年注意缺陷与多动障碍：治疗和预后概述”和“儿童和青少年注意缺陷多动障碍：流行病学与发病机制”和“儿童和青少年注意力缺乏多动障碍治疗药物的药理学”)

药物治疗概述

药物治疗是ADHD的一线治疗。咨询和特定的心理治疗可能是帮助患者调整紊乱的生活模式的有效辅助手段。 (参见“成人注意缺陷与多动障碍的心理治疗”)

通过中枢神经系统(central nervous system, CNS)的去甲肾上腺素通路起效的药物似乎能最直接地治疗ADHD[5,6]。兴奋剂是儿童药物治疗的一个主要组成部分[7,8]，而兴奋剂和抗抑郁药(尤其是那些具有去甲肾上腺素活性的药物)是用于治疗成人ADHD的主要药物。可使用的药物和剂量如表所示(表 1)。

                     

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-05.
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