治疗多动症的目的通常是减轻症状,但不应该是唯一的标准。我们的目标应该可以改善在现实世界中的作用,根据Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)。This includes being self-sufficient, being able to cope with the demands of daily life, and having a better quality of life than one would have without treatment. Treatment for ADHD includesbehavioral strategies,用药,家长培训,并coaching。
According to多动症家长用药指南, medication "plays an important role in the treatment of children, adolescents and adults with ADHD…for most people with ADHD, medication dramatically reduces多动症, improves attention and increases the ability to get along with others.” It also notes that children with ADHD who have other mental health conditions, such as萧条和焦虑,尤其受到其个人和家庭治疗作为他们的治疗计划的一部分帮助。
药物不能治愈多动症。但它确实有助于减少拍摄时,按规定的症状。
如何用药帮助
Approximately 80 percent of people respond positively to stimulant medications according toCHADD。They work by affecting the neurotransmitters dopamine and norepinephrine, in the brain and enable networks of nerve cells in the brain to communicate more effectively with each other. Medications help most people with ADHD feel calmer and more able to focus and concentrate. They should not change a person’s personality, but might make them less hyperactive and more attentive.
药物有助于提高注意力和重点,同时减少多动和冲动。很多人注意到挫折的承受力和报告服用药物导致的改进在关系改善与父母、配偶、同伴和教师。
Not everyone finds that medications work. Some find the benefits extraordinary, while some see modest improvements.
Types of medications for ADHD
用于治疗多动症最常见的药物是精神兴奋剂,如:
- 哌醋甲酯(利他林,使用Concerta,历史沿革资料,DAYTRANA,Methylin,Quillivant)
- 安非他明(Adderall的,Eveko,Adzenys)
- Dextroamphetamines (Dexedrine, ProCentra, Zenzedi)
- 右哌甲酯(Focalin)
- Lisdexamfetamine (Vyvanse)
Stimulant medications开始服药后工作30至90分钟。短效药物,去年四到六小时。许多人在缓释(XR,ER)可用,从六个到12个小时随时随地持久,这取决于药物和剂量。
也有非兴奋剂药物(托莫西汀,可乐定,胍法辛),这是由FDA在ADHD的治疗中获得批准。可乐定可组合使用兴奋剂来提高其有效性。凡兴奋剂药物立即生效,并影响持续的时间很短,这些药物必须每天采取有效。但是,你或你的孩子可能感觉不到全效为三到四个星期。
Other medications include antidepressants, antihypertensive medications, and wake-promoting medications, such as those used to treat narcolepsy. These can be tried if psychostimulants or non-stimulant medications are not effective or not well tolerated.
多动症药物的副作用
最常见的兴奋剂药物的副作用are reduced appetite and difficulty sleeping. These are usually short-term and frequently go away after a few weeks. Some people have headaches or stomachaches, but this also usually disappears after taking medication for a few weeks.
身高和体重应该由医生进行监测。兴奋剂使用可与生长少量减少相关联。按照ADHD的综合治疗研究, this may continue into adulthood.
治疗儿童六岁以下
For children under the age of six, theAmerican Academy of Pediatrics (AAP)建议behavior therapy作为治疗的第一线, before trying medication. The AAP found many preschool age children with moderate to severe dysfunction had improved symptoms with behavioral therapy alone. If no significant improvement is seen with behavior therapy, then methylphenidate can be prescribed.
For children older than six, medications combined with behavior therapy is recommended. Stimulant medications have shown the best results, but non-stimulants and clonidine will work if stimulants are not tolerated.
长期使用刺激性药物
TheADHD的综合治疗研究(MTA)随访579个孩子谁是在1999年7至10岁之间,研究的第一年。参与者被随机分为四组:药物治疗,药物加行为疗法,行为疗法只,或社区护理,这是保健组织和家长的监督。他们强化治疗14个月。
The study found that medication was most effective. After the 14 months, treatment continued or didn’t based on parents’ discretion, but researchers still followed up with participants periodically and the results were published every few years. The most recent update was in March 2017. This follow-up confirmed that reduced height, by an average of 2.36 centimeters (about one inch), was still present in those that took stimulants.
A previous follow up, in 2007, had found that medications seemed to lose their effectiveness around three years after starting them. The follow up in 2016 found that more than 60 percent of the participants continued to have ADHD symptoms, regardless of whether they used medication or not. The most recent, in March 2017, found that symptom severity was not any different in those who took medication and those who didn’t.
这使人们怀疑治疗是否是值得的,还是这只是一个很短的时间有效。Dr. Steve Hinshaw在加州大学伯克利分校的心理学教授,是不知道的是,MTA表明,药物是不能奏效的。
在本文发表于Wire Cognitive Science, he states it could be that intensive treatment with medication wasn’t necessarily occurring throughout the years; that the monitoring by parents that was apparent during the initial phase of the study was not present after the initial 14 months; or that some people may experience a burnout of the dopamine receptors, and that would make medication less effective.
“当ADHD药物工作,许多多动症的症状消失。这种情况并不少见,但是,对于一些症状留连忘返。行为治疗可以用剩下的症状有所帮助,”根据多动症家长用药指南。
服药是有效的对许多人来说仍然是正确的。它是由你和你的医生监视该有效性和继续评估它的好处。