注意缺陷多动障碍的治疗药物进展.pdf

注意缺陷多动障碍注意缺陷多动障碍的治疗药物的治疗药物进展进展 注意缺陷多动障碍注意缺陷多动障碍的的治疗药物治疗药物进展进展 范洲际 李允武 （上海交通大学医学院附属第九人民医院 上海 200011 ） 摘要 药物治疗是目前治疗注意缺陷多动障碍的主要手段。中枢兴奋剂作为ADHD 的一线治 疗药，已有数十年历史，并始终是临床研究的热点。近年来开发应用的新型释药系统，大大推 动了中枢兴奋剂新制剂的广泛研究和临床应用。与常规速释制剂相比，新型长效制剂具有药效 持续时间长、只需每天服药一次、不良反应相对较少等特点，为患者的临床用药提供了更多选 择。非中枢兴奋剂药物托莫西汀、抗抑郁剂、α2 肾上腺素能受体激动剂等研究证明对治疗 ADHD 有肯定的疗效，其中托莫西汀作为唯一获美国FDA 批准的非中枢兴奋剂药物，在国外 已被列为ADHD 的一线治疗新药。其它如莫达非尼、胍法新等作为潜在的ADHD 治疗新药， 正日益受到广泛关注。 关键词 注意缺陷多动障碍；中枢兴奋剂；非中枢兴奋剂；哌甲酯；苯丙胺；托莫西汀 Advances in pharmacologic treatment of attention deficit hyperactivity disorder FAN Zhou-ji LI Yun-wu Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China Abstracts: Pharmacotherapy is the major alternative to treatment of attention-deficit/ hyperactivity disorder (ADHD). The stimulant medications have been used for decades as first-line therapy for the treatment of ADHD, and have always been actively studied. To develop and use more efficacious, better-tolerated stimulant formulations with newly improved drug delivery systems have driven recent research in ADHD. Compare with immediate-release formulations, the new long-acting formulations have the benefit of longer duration of therapeutic effects, only once-daily is required, and one may be better tolerated for common side defects. Nonstimulants, including atomoxetine, antidepressa