A Review of the Pathophysiology, Etiology, and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD)

Annals of Pharmacotherapy - Tập 48 Số 2 - Trang 209-225 - 2014
Alok Sharma1, Justin Couture2
1MCPHS University, Worcester/Manchester, NH, USA.
21MCPHS University, Worcester/Manchester, NH, USA

Tóm tắt

Objective: To review the pathophysiology, etiology, and treatment of attention-deficit hyperactivity disorder (ADHD). Data Sources and Data Extraction: A literature search was conducted in PubMed and EMBASE using the terms attention deficit hyperactive disorder, ADHD, pathophysiology, etiology, and neurobiology. Limits applied were the following: published in the past 10 years (January 2003 to August 2013), humans, review, meta-analysis, and English language. These yielded 63 articles in PubMed and 74 in EMBASE. After removing duplicate/irrelevant articles, 86 articles and their relevant reference citations were reviewed. Data Synthesis: ADHD is a neurological disorder that affects children, but symptoms may persist into adulthood. Individuals suffering from this disorder exhibit hyperactivity, inattention, impulsivity, and problems in social interaction and academic performance. Medications used to treat ADHD such as methylphenidate, amphetamine, and atomoxetine indicate a dopamine/norepinephrine deficit as the neurochemical basis of ADHD, but the etiology is more complex. Moreover, these agents have poor adverse effect profiles and a multitude of drug interactions. Because these drugs are also dispensed to adults who may have concomitant conditions or medications, a pharmacist needs to be aware of these adverse events and drug interactions. This review, therefore, focuses on the pathophysiology, etiology, and treatment of ADHD and details the adverse effects and drug interaction profiles of the drugs used to treat it. Conclusions: Published research shows the benefit of drug therapy for ADHD in children, but given the poor adverse effect and drug interaction profiles, these must be dispensed with caution.

Từ khóa


Tài liệu tham khảo

Berger I, 2011, Isr Med Assoc J, 13, 571

10.2165/11599580-000000000-00000

10.1176/appi.books.9780890425596

10.1016/j.ejpn.2012.01.009

10.2146/ajhp040600

10.1016/j.pbb.2013.01.021

Modesto-Lowe V, 2012, Conn Med, 76, 517

10.4088/JCP.v67n0403

10.1016/j.pbb.2011.01.020

10.1016/j.nlm.2011.07.002

10.1073/pnas.0707741104

10.1093/cercor/bhm033

10.1016/j.tics.2010.05.003

10.1016/j.biopsych.2004.08.026

10.1097/00019052-200312002-00001

10.1523/JNEUROSCI.5094-09.2010

10.1016/j.cell.2007.03.015

10.1016/j.neuropharm.2009.07.026

10.1176/appi.ajp.2011.11060940

10.1007/s00439-009-0694-x

10.1523/JNEUROSCI.0473-08.2008

10.1523/JNEUROSCI.6033-11.2012

10.1097/00004583-198201000-00004

10.1016/S0166-4328(03)00097-4

10.1007/s11011-012-9287-9

10.1097/00002826-200101000-00002

10.1016/j.chc.2007.11.002

10.1016/j.biopsych.2005.01.034

10.1080/15622970802176032

10.1017/S0954579408000539

10.1016/j.neuropharm.2009.08.001

10.1345/aph.10353

American Psychiatric Association, 2000, Diagnostic and Statistical Manual of Mental Disorders, 4

10.1016/j.biopsycho.2011.09.011

Rader R, 2009, Am Fam Physician, 79, 657

10.1097/01.CHI.0000070245.24125.B6

10.1097/chi.0b013e318054e724

10.1177/1087054713495736

10.1056/NEJM199903113401007

10.1586/14737175.8.10.1537

10.1016/j.psc.2010.04.001

A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder, 1999, Arch Gen Psychiatry, 56, 1073, 10.1001/archpsyc.56.12.1073

10.1542/peds.113.4.754

10.1097/CHI.0b013e3180686d48

10.1097/CHI.0b013e31819c23d0

10.1592/phco.29.6.656

10.1177/1087054708319345

10.1177/1087054708319525

10.1037/1064-1297.13.2.111

10.1089/cap.2008.0128

10.1146/annurev.pa.33.040193.003231

10.1016/0166-2236(93)90010-J

10.1001/archpsyc.1995.03950180042006

10.1007/s11065-006-9017-3

10.1016/j.clinthera.2006.03.006

10.1001/archpedi.160.1.82

10.1517/14656566.9.9.1565

10.1016/j.biopsych.2007.04.015

10.1016/S0140-6736(07)60464-4

10.1016/j.biopsych.2006.04.022

10.1542/peds.104.2.e20

Biederman J, 2003, J Clin Psychiatry, 64, 3

10.1176/appi.ajp.2008.07091465

10.1177/1087054710365054

10.1542/peds.2008-3347

10.1097/00004583-200203000-00004

10.1089/cap.2005.15.799

10.1037/a0023825

10.1177/1087054708329781

10.1016/j.neubiorev.2010.03.006

10.1016/j.jaac.2010.06.015

10.1016/j.jpeds.2010.04.025

10.1097/00004583-199701000-00021

10.1136/adc.2004.056952

10.1089/cap.2005.15.191

Faraone SV, 2008, J Am Acad Child Adolesc Psychiatry, 47, 994

10.1542/peds.113.4.762

10.1097/01.chi.0000235075.25038.5a

10.1097/00004583-199611000-00014

10.1097/01.chi.0000205702.48324.fd

10.1176/appi.ajp.2008.08050781

10.1177/1087054709356406

10.1056/NEJMp068049

10.1542/peds.109.3.e39

10.1097/01.chi.0000220847.41027.5d

10.1017/S1092852900000353

Shier AC, 2012, J Cent Nerv Syst Dis, 5, 1

10.1586/14737175.5.3.325

10.1007/s00787-009-0054-3

10.1176/ajp.155.10.1325

10.1176/appi.ajp.161.7.1173

10.1023/B:PHAM.0000003389.77585.be

Ritalin (methylphenidate hydrochloride tablet) [product information]. East Hanover, NJ: Novartis Pharmaceuticals; 2007.

Concerta (methylphenidate hydrochloride tablet) [product information]. Vacaville, CA: Janssen-Cilag; 2010.

Metadate CD (methylphenidate hydrochloride capsule) [product information]. Smyrna, GA: UCB Manufacturing; 2013.

Focalin (dexmethylphenidate hydrochloride capsule) [product information]. East Hanover, NJ: Novartis Pharmaceuticals; 2013.

Daytrana (methylphenidate transdermal system) [product information]. Miami, FL: Noven Pharmaceuticals; 2010.

10.1016/S0031-3955(16)36764-5

10.1586/14737175.5.1.107

10.1016/S0009-9236(99)70038-X

10.1001/archpsyc.60.2.204

10.1016/j.neubiorev.2003.08.013

10.2165/00003495-200666080-00007

Adderall (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate tablet) [product information]. North Wales, PA: Teva Pharmaceuticals; 2012.

Vyvanse (lisdexamfetamine dimesylate) [product information]. Chesterbrook, PA: Shire US; 2013.

10.1177/1087054706295605

10.1016/j.psc.2003.12.001

Waxmonsky JG, 2005, Essent Psychopharmacol, 6, 262

Faraone SV, 2009, P T, 34, 678

10.4088/JCP.08m04902pur

10.1177/1087054710379737

10.1097/00004583-200202001-00003

Wernicke JF, 2002, J Clin Psychiatry, 63, 50

10.1016/S0893-133X(02)00346-9

10.1126/science.1121218

10.1016/j.biopsych.2007.03.003

10.1007/s00787-004-1010-x

10.1016/j.jaac.2010.07.011

10.1111/j.1744-6171.2006.00044.x

Strattera (atomoxetine hydrochloride) [product information]. Indianapolis, IN: Eli Lilly; 2012.

Intuniv (guanfacine) [product information]. Chesterbrook, PA: Shire US; 2011.

Kapvay (clonidine hydrochloride) [product information]. Florham Park, NJ: Shionogi; 2013.

10.1017/S1092852900018460

10.1007/BF00169548

10.1097/01.chi.0000215326.51175.eb

10.1097/01.chi.0000153225.26850.26

Wellbutrin (bupropion hydrochloride) [product information]. Research Triangle Park, NC: GlaxoSmithKline; 2013.

10.1016/j.pbb.2005.08.002

10.1097/FBP.0b013e32831c3b06

10.1176/ajp.156.12.1931

10.1542/peds.2011-2654

Thông tin
Thông tin xuất bản

Annals of Pharmacotherapy

Tập 48 Số 2

209-225

Thông tin tác giả