成人注意力缺陷/多动障碍的流行病学研究和药物治疗进展

摘要/Abstract

摘要： 注意力缺陷/多动障碍（attention deficit/hyperactivity disorder，ADHD）是儿童最常见的一种神经发育异常疾病，绝大多数儿童期的ADHD患者将持续带入到成人期。2012年由美国精神病学协会颁布的DSM-5首次给出了成人ADHD的诊断，规范了成人ADHD的治疗。目前主要的治疗药物包括哌甲酯、苯丙胺类神经兴奋剂类，托莫西汀、安非他酮和三环类抗抑郁药等非兴奋剂类，其它药物如文拉法辛、瑞波西汀、莫达非尼、奥卡西平、普萘洛尔等也被尝试用于治疗成人ADHD，并取得一定疗效。

关键词: 注意力缺陷/多动障碍, 诊断, 治疗

Abstract: Attention deficit/hyperactivity disorder (ADHD) is the most frequently diagnosed neuro-developmental disorder
in children and most of the children ADHD cases can persist to adulthood. The DSM-5 developed and published by American Psychiatric Association (APA) at 2012 firstly gives the more appropriate diagnosis criteria and pharmacotherapy guidelines for adult ADHD. The currently used medications include neural
stimulants (e.g. methylphenidate and amphetamines) and non-stimulants (e.g. atomoxetine, buproprion and tricyclic antidepressants). Other medications such as venlafaxine, reboxetine, modafinil, oxcarbazepine and propranolol are also tested to treat adult ADHD and showed some therapeutic effects.

Key words: attention deficit/hyperactivity disorder, diagnosis, treatment

刘治军. 成人注意力缺陷/多动障碍的流行病学研究和药物治疗进展[J]. 神经药理学报, 2012, 2(5): 31-39.

LIU Zhi-jun. Epidemiology and Pharmacotherapy of Adult Attention Deficit/Hyperactivity Disorde: Current Status[J]. Acta Neuropharmacologica, 2012, 2(5): 31-39.

参考文献

[1] Lenard A Adler. Familial transmission of ADHD and psychoactive substance use disorders[J]. Am J Psychiatry, 2008, 165(1): 11-12.

[2] Per Kristian Goksøyr, Jim Aage Nøttestad. The burden of untreated ADHD among adults: the role of stimulant medication[J]. Addict Behav, 2008, 33(2): 342-346.

[3] Marlous Tuithof, Margreet ten Have, Wim van den Brink, et al. The role of conduct disorder in the association between ADHD and alcohol use (disorder). Results from the Netherlands Mental Health Survey and Incidence Study-2[J]. Drug Alcohol Depend, 2012, 123(1-3): 115-121.

[4] Rio Bianchini, Valentina Postorino, Rita Grasso, et al. Prevalence of ADHD in a sample of Italian students: a population-based study[J]. Res Dev Disabil, 2013, 34(9):2543-2550.

[5] J Fayyad, R De Graaf, R Kessler, et al. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder[J]. Br J Psychiatry, 2007, 190:402-409.

[6] Ronald C Kessler, Lenard Adler, Russell Barkley, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication[J]. Am J Psychiatry, 2006, 163(4):716-723.

[7] Albert J Arias, Joel Gelernter, Grace Chan, et al. Correlates of co-occurring ADHD in drug-dependent subjects: prevalence and features of substance dependence and psychiatric disorders[J]. Addict Behav, 2008, 33(9):1199-1207.

[8] Daigre Blanco C, Ramos-Quiroga JA, Valero S, et al. Adult ADHD Self-Report Scale (ASRS-v1.1) symptom checklist in patients with substance use disorders[J]. Actas Esp Psiquiatr, 2009, 37(6):299-305.

[9] Katelijne van Emmerik-van Oortmerssen, Geurt van de Glind, Wim van den Brink, et al. Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis[J]. Drug Alcohol Depend, 2012, 122(1-2):11-19.

[10] M D Rodrigo, D Perera, V P Eranga, et al. The knowledge and attitude of primary school teachers in Sri Lanka towards childhood attention deficit hyperactivity disorder[J]. Ceylon Med J, 2011, 56(2):51-54.

[11] Ahmad Ghanizadeh, Nabi Zarei. Are GPs adequately equipped with the knowledge for educating and counseling of families with ADHD children?[J]. BMC Fam Pract, 2010, 11:5.

[12] Regina Bussing, BonnieT Zima, Dana M Mason, et al. ADHD knowledge, perceptions, and information sources: perspectives from a community sample of adolescents and their parents[J]. J Adolesc Health, 2012, 51(6):593-600.

[13] The ADHD and Disruptive Behavior Disorders Work Group. ADHD and Disruptive Behavior Disorders [N/OL]. http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=383.

[14] S Dalsgaard. Attention-deficit/hyperactivity disorder (ADHD) [J]. Eur Child Adolesc Psychiatry, 2013, 22(Suppl 1):S43-S48.

[15] Thomas Spencer, Joseph Biederman, Timothy Wilens. A large double blind clinical trial of methylphenidate in the treatment of adults with attention deficit/hyperactivity disorder[J]. Biol Psychiatry, 2005, 57(5): 456-463.

[16] J J S Kooij, H Burger, A M Boonstra. Efficacy and safety of methylphenidate in 45 adults with attention deficit/hyperactivity disorder: a randomized placebo controlled double blind crossover trial[J]. Psychol Med, 2004, 34(6): 973-982.

[17] J C Verster, E M Bekker, M de Roos, et al. Methylphenidate significantly improves driving performance of adults with attention-deficit hyperactivity disorder: a randomized crossover trial[J]. J Psychopharmacol, 2008, 22 (3): 230-237.

[18] S Kuperman, P J Perry, G R Gaffney, et al. Bupropion SR vs. methylphenidate vs. placebo for attention deficit hyperactivity disorder in adults[J]. Ann Clin Psychiatry, 2001, 13(3): 129-134.

[19] Peter J Carpentier, Cor A J De Jong, Boukje A G Dijkstra, et al. A controlled trial of methylphenidate in adults with attention deficit/hyperactivity disorder and substance misuse disorders[J]. Addiction, 2005, 100(12): 1868-1874.

[20] J Godfrey. Safety of therapeutic methylphenidate in adults: a systematic review of the evidence[J]. J Psychopharmacol, 2009, 23 (2): 194-205.

[21] Weiss M, Hechtman L, Adult ADHD Research Group.A randomized double-blind trial of paroxetine and/or dextroamphetamine and problem-focused therapy for attention-deficit/hyperactivity disorder in adults[J]. J Clin Psychiatry, 2006, 67(4): 611-619.

[22] F B Taylor, J Russo. Comparing guanfacine and dextroamphetamine for the treatment of adult attentiondeficit/hyperactivity disorder[J]. J Clin Psychopharmacol, 2001, 21 (2): 223-228.

[23] Fletcher B Taylor, Joan Russo. Efficacy of modafinil compared to dextroamphetamine for the treatment of attention deficit hyperactivity disorder in adults[J]. J Child Adolesc Psychopharmacol, 2000, 10 (4): 311-320.

[24] Thomas Spencer, Joseph Biederman, Timothy Wilens, et al. Efficacy of amixed amphetamine salts compound in adults with attentiondeficit/hyperactivity disorder[J]. Arch Gen Psychiatry, 2001, 58(8): 775-782.

[25] R Paterson, C Douglas, J Hallmayer, et al. A randomised, double blind, placebo controlled trial of dexamphetamine in adults with attention hyperactivity disorder[J]. Aust N Z J Psychiatry, 1999, 33(4): 494-502.

[26] Michael Rosler, Roland Fischer, Richard Ammer, et al. A randomised, placebo-controlled, 24-week, study of low-dose extended-release methylphenidate in adults with attention-deficit/hyperactivity disorder[J]. Eur Arch Psychiatry Clin Neurosci, 2009, 259 (2): 120-129.

[27] Umesh Jain, Lily Hechtman, Margaret Weiss, et al. Efficacy of a novel biphasic controlled-release methylphenidate formula in adults with attention-deficit/hyperactivity disorder: results of a double-blind, placebo-controlled crossover study[J]. J Clin Psychiatry, 2007, 68(2): 268-277.

[28] Joseph Biederman, Eric Mick, Craiq Surman, et al. A randomised placebo controlled trial of OROS methylphenidate in adults with attention deficit/hyperactivity disorder[J]. Biol Psychiatry, 2006, 59(9): 829-835.

[29] Frederick W Reimherr, Erika D Williams. A double-blind, placebocontrolled, crossover study of osmotic release oral system methylphenidate in adults withADHDwith assessment of oppositional and emotional dimensions of the disorder[J]. J Clin Psychiatry, 2007, 68 (1): 93-101.

[30] L A Adler, B Zimmerman, H L Starr, et al. Efficacy and safety of OROS methylphenidate in adults with attentiondeficit/hyperactivity disorder: a randomized, placebocontrolled, double-blind, parallel group, dose-escalation study[J]. J Clin Psychopharmacol, 2009, 29(3): 239-247.

[31] Rossella Medori, J Antoni Ramos-Quiroga, Miquel Casas, et al. A randomized, placebo-controlled trial of three fixed dosages of prolonged-release OROS methylphenidate in adults with attention-deficit/hyperactivity disorder[J]. Biol Psychiatry, 2008, 63 (10): 981-989.

[32] Thomas J Spencer, Lendard A Adler, James J McGough, et al. Efficacy and safety of dexmethylphenidate extended-release capsules in adults with attention-deficit/hyperactivity disorder[J]. Biol Psychiatry, 2007, 61(12): 1380-1387.

[33] L A Adler, Spencer T, J J McGough, et al. Long-term effectiveness and safety of dexmethylphenidate extendedrelease capsules in adult ADHD[J]. J Atten Disord, 2009, 12(5): 449-459.

[34] R H Weisler, J Biederman, T Spencer, et al. Mixed amphetamine salts extended-release in the treatment of adult ADHD: a randomized, controlled trial[J]. CNS Spectr, 2006, 11 (8): 625-639.

[35] Lenard A Adler, David W Goodman, Scott H Kollins, et al. Double-blind, placebo-controlled study of the efficacy and safety of lisdexamfetamine dimesylate in adults with attentiondeficit/hyperactivity disorder[J]. J Clin Psychiatry, 2008, 69(9): 1364-1373.

[36] Richard Weisler, Joel Young, Greg Mattingly, et al. Long-term safety and effectiveness of lisdexamfetamine dimesylate in adults with attention-deficit/hyperactivity disorder[J]. CNS Spectr, 2009, 14(10): 573-585.

[37] Timothy Wigal, Matthew Brams, Maria Gasior, et al. Randomized, double-blind, placebo-controlled, crossover study of the efficacy and safety of lisdexamfetamine dimesylate in adults with attention deficit/hyperactivity disorder: novel findings using a simulated adult workplace environment design[J]. Behav Brain Funct, 2010, 6: 34.

[38] David Michelson, Lenard Adler, Thomas Spencer, et al. Atomoxetine in adults with ADHD: two randomised placebo-controlled studies[J]. Biol Psychiatry, 2003, 53(2): 112-120.

[39] L A Adler, T Spencer, T E Brown, et al. Once-daily atomoxetine for adult attention-deficit/hyperactivity disorder: a 6-month, double-blind trial[J]. J Clin Psychopharmacol, 2009, 29(1): 44-50.

[40] Mats Johnson, Mats Cederlund, Maria Rastam, et al. Open-label trial of atomoxetine hydrochloride in adults with ADHD[J]. J Atten Disord, 2010, 13(5): 539-545.

[41] Lenard A Adler, Thomas J Spencer, David W Williams, et al. Long-term, open-label safety and efficacy of atomoxetine in adults with ADHD: final report of a 4-year study[J]. J Atten Disord, 2008, 12(3): 248-253.

[42] Lenard A Adler, Michael Liebowitz, William Kronenberger, et al. Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder[J]. Depress Anxiety, 2009, 26 (3): 212-221.

[43] L Adler, A Dietrich, F Reimherr, et al. Safety and tolerability of once versus twice daily atomoxetine in adults with ADHD[J]. Ann Clin Psychiatry, 2006, 18 (2): 107-113.

[44] Timothy E Wilens, Thomas J Spencer, Joseph Biederman, et al. A controlled clinical trial of buproprion for attention deficit hyperactivity disorder in adults[J]. Am J Psychiatry, 2001, 158(2): 282-288.

[45] Timothy E Wilens, Barbara R Haight, Joseph P Horrigan, et al. Buproprion XL in adults with attention-deficit/hyperactivity disorder: a randomized placebo-controlled study[J]. Biol Psychiatry, 2005, 57(7): 793-801.

[46] T E Wilens, J Biederman, J Prince, et al. Six-week, doubleblind, placebo-controlled study of desipramine for adult attention deficit hyperactivity disorder[J]. Am J Psychiatry, 1996, 153(9): 1147-1153.

[47] Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA). Canadian ADHD practice guidelines[M]. 2nd. Toronto (ON): CADDRA, 2008.

[48] Lourdes Villalba. Safety review: sudden death with drugs used to treat ADHD [N/OL]. Http://www.fda.gov/ohrms/dockets/ac/06/briefing/2006-4210b_07_01_safetyreview.pdf.

[49] Eli Lilly and Company Ltd. Strattera 10 mg, 18mg, 25 mg, 40 mg, 60mg or 80mg hard capsules: summary of product characteristics [N/OL]. http://emc.medicines.org.uk.