注意缺陷/多动障碍(ADHD)是一种神经发育障碍,其特征是持续的注意力不集中。多动症,和冲动。这是儿科服务中最常见的神经发育障碍,儿科医生经常参与早期评估,诊断,和治疗儿童多动症。多动症的治疗通常涉及多模式方法,包括心理教育的组合,家长/教师培训,社会心理/心理治疗干预,和药物治疗。关于药物治疗,指南在药物选择和测序方面各不相同,用精神兴奋剂,如哌醋甲酯和(LIS)右旋氨胺,通常是首选的初始治疗。替代品包括托莫西汀和胍法辛。药物治疗被证明是有效的,但是密切关注身体生长,心血管监测,以及对包括抽搐在内的潜在副作用的监测,情绪波动,和精神病症状,是必不可少的。本文概述了当前ADHD的药物治疗方案,并探讨了不同欧洲国家治疗指南的差异。结论:儿童和青少年ADHD的药物治疗方案有效且耐受性良好。ADHD的药物治疗始终是多模式方法的一部分。虽然欧洲关于ADHD药物治疗的指南有相当大的共识,存在显著差异,特别是关于各种药物的选择和排序。已知:•对于儿童和青少年中的ADHD,存在药物治疗的重要证据基础。•儿科医生经常参与评估,儿童多动症的诊断和治疗。新增内容:•我们对不同欧洲指南的概述揭示了在儿童和青少年ADHD药物治疗方面的重要共识。•差异主要存在于不同药物的选择和排序方面。
Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by a persistent pattern of inattention, hyperactivity, and impulsivity. It is the most common neurodevelopmental disorder presenting to pediatric services, and pediatricians are often involved in the early assessment, diagnosis, and treatment of children with ADHD. The treatment of ADHD typically involves a multimodal approach that encompasses a combination of psychoeducation, parent/teacher training, psychosocial/psychotherapeutic interventions, and pharmacotherapy. Concerning pharmacotherapy,
guidelines vary in drug choice and sequencing, with psychostimulants, such as methylphenidate and (lis)dexamfetamine, generally being the favored initial treatment. Alternatives include atomoxetine and guanfacine. Pharmacotherapy has been proven effective, but close follow-up focusing on physical growth, cardiovascular monitoring, and the surveillance of potential side effects including tics, mood fluctuations, and psychotic symptoms, is essential. This paper presents an overview of current pharmacological treatment options for ADHD and explores disparities in treatment
guidelines across different European countries. Conclusion: Pharmacological treatment options for ADHD in children and adolescents are effective and generally well-tolerated. Pharmacotherapy for ADHD is always part of a multimodal approach. While there is a considerable
consensus among European
guidelines on pharmacotherapy for ADHD, notable differences exist, particularly concerning the selection and sequencing of various medications. What is Known: • There is a significant base of evidence for pharmacological treatment for ADHD in children and adolescents. • Pediatricians are often involved in assessment, diagnosis and management of children with ADHD. What is New: • Our overview of different European
guidelines reveals significant agreement in the context of pharmacotherapy for ADHD in children and adolescents. • Discrepancies exist primarily in terms of selection and sequencing of different medications.