注意力不足過動症的治療：修订间差异

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===神經回饋===
===神經回饋===
{{link-en|神經回饋|Neurofeedback}}（NF）是一種針對患有兒童、青少年或是成人的治療方式<ref name=Greydanus_Pratt_Patel>{{cite journal|pmid=17386306|last1=Greydanus|first1=DE|last2=Pratt|first2=HD|last3=Patel|first3=DR|title=Attention deficit hyperactivity disorder across the lifespan: the child, adolescent, and adult|journal=Disease-a-month|volume=53|issue=2|pages=70–131|date=February 2007|doi=10.1016/j.disamonth.2007.01.001}}</ref>。此療法會用電極來測量人腦所釋放的電能。當有beta波出現時會發出警告，此理論認為罹患ADHD的人可以透過訓練來降低ADHD的症狀{{citation needed|date=June 2013}}。
當前腦波回饋是否具有療效仍然未知<ref>{{cite journal|last1=Cortese|first1=S|last2=Ferrin|first2=M|last3=Brandeis|first3=D|last4=Holtmann|first4=M|last5=Aggensteiner|first5=P|last6=Daley|first6=D|last7=Santosh|first7=P|last8=Simonoff|first8=E|last9=Stevenson|first9=J|last10=Stringaris|first10=A|last11=Sonuga-Barke|first11=EJ|last12=European ADHD Guidelines Group|first12=(EAGG).|title=Neurofeedback for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and Neuropsychological Outcomes From Randomized Controlled Trials.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=2016-06|volume=55|issue=6|pages=444-55|doi=10.1016/j.jaac.2016.03.007|pmid=27238063}}</ref>。
{{trans H}}
In general no effects have been found in the most blinded ADHD measures, which could be indicating that positive results are due to the placebo effect.<ref name=pmid25220087>{{cite journal|last1=Holtmann|first1=M|last2=Sonuga-Barke|first2=E|last3=Cortese|first3=S|last4=Brandeis|first4=D|title=Neurofeedback for ADHD: A Review of Current Evidence|journal=Child and Adolescent Psychiatric Clinics of North America|date=October 2014|volume=23|issue=4|pages=789–806|pmid=25220087|doi=10.1016/j.chc.2014.05.006|url=https://biblio.ugent.be/publication/5841198|hdl=1854/LU-5841198}}</ref>
{{trans F}}


目前還沒看到神經回饋療法有造成嚴重的不良反應<ref name="pmid22930416">{{cite journal |vauthors=Moriyama TS, Polanczyk G, Caye A, Banaschewski T, Brandeis D, Rohde LA |title=Evidence-based information on the clinical use of neurofeedback for ADHD |journal=Neurotherapeutics |volume=9 |issue=3 |pages=588–98 |date=July 2012 |pmid=22930416 |doi=10.1007/s13311-012-0136-7 |url= |pmc=3441929}}</ref>，有關神經回饋的研究，目前還沒有高品質的成果<ref name="pmid22930416" />。目前有些有關神經回饋成效的資訊，不過說服力還不足：不少研究有正面的結果，不過設計的最好的實驗無法看出其成效，或是成效較弱{{Failed verification|date=August 2016}}<ref name="pmid22930416" /><ref name="pmid22890816">{{cite journal |vauthors=Lofthouse N, Arnold LE, Hurt E |title=Current status of neurofeedback for attention-deficit/hyperactivity disorder |journal=Curr Psychiatry Rep |volume=14 |issue=5 |pages=536–42 |date=October 2012 |pmid=22890816 |doi=10.1007/s11920-012-0301-z |url=}}</ref>。在大部份的雙盲實驗中，看不出神經回饋的效果，因此正面效果也有可能是類似心理作用的安慰劑效應<ref name=pmid25220087>{{cite journal|last1=Holtmann|first1=M|last2=Sonuga-Barke|first2=E|last3=Cortese|first3=S|last4=Brandeis|first4=D|title=Neurofeedback for ADHD: A Review of Current Evidence|journal=Child and Adolescent Psychiatric Clinics of North America|date=October 2014|volume=23|issue=4|pages=789–806|pmid=25220087|doi=10.1016/j.chc.2014.05.006|url=https://biblio.ugent.be/publication/5841198|hdl=1854/LU-5841198}}</ref>。
=== 飲食===
=== 飲食===
{{main|飲食與注意力不足過動症的關係}}
{{main|飲食與注意力不足過動症的關係}}

2019年12月23日 (一) 14:14的版本

维基百科中的醫學内容仅供参考，並不能視作專業意見。如需獲取醫療幫助或意見，请咨询专业人士。詳見醫學聲明。

注意力不足過動症的治療是指在注意力不足過動症（ADHD）治療上，以醫學實證為基礎，已確認有一定程度治療效果的治療方式。注意力不足過動症的治療包括心理治療、行為治療及藥物，也有可能是用心理治療配合藥物進行治療。治療對病症會有長期的改善，但是無法完全根除病症的影響[1]。

美國兒科學會針對病患的年齡不同，有建議不同的治療方式。若是四歲至五歲的兒童，學會會建議有實證基礎，且由家長或／和老師監督的行為治療，只有在有中度到重度，持續性的功能紊亂時，才加上哌甲酯的藥物治療。若是六歲至十一歲的兒童，會建議使用藥物以及行為治療；而「中樞神經刺激劑」的藥效會比「非中樞神經刺激劑」的藥效要明顯一些，雖然「中樞神經刺激劑」和「非中樞神經刺激劑」都能讓孩子核心症狀減少的程度在統計學上達到明顯意義[2]。若是十二歲至十八歲的患者，強烈建議使用藥物治療，但用藥仍需取得患者的同意；藥物治療之餘也建議能搭配行為治療[2][3]。有其他研究指出若能合併藥物治療及行為治療、認知行為治療等心理治療，將可帶來更樂觀的預後[3]。

針對注意力不足過動症的藥物治療，有許多中樞神經刺激劑及非中樞神經刺激劑的藥物。最常用的中樞神經刺激劑有哌甲酯（利他能、學思達）、阿得拉尔（Adderall, Mydayis）、右旋安非他命（Dexedrine）及甲磺酸赖氨酸安非他命（Vyvanse）。專門用來治療ADHD的非中樞神經刺激劑有阿托莫西汀（Strattera）、胍法辛（Intuniv）及可乐定（Kapvay）。其他處方外使用（英语：off-labell）的藥物有安非他酮（Wellbutrin）、三环类抗抑郁药、5-羟色胺和去甲肾上腺素再摄取抑制剂或是单胺氧化酶抑制剂[4][5][6]。若有罹患相關的疾病，會使得診斷及找到正確治療方式的過程更困難及費時，因此建議同步評估是否有罹患注意力不足過動症的相關疾病，若有，也需同步進行治療[7]。

在注意力不足過動症的非藥物治療上，有許多心理治療及行為改變（英语：behavior modification）的方式，其中包括心理治療以及工作記憶訓練（英语：working memory training）。透過父母管理訓練及教室經營（英语：classroom management）調整家庭及學校的互動方式，也可以提昇兒童的行為表現[8]。專門的ADHD教練也可以提供改善日常行為的方式及策略，例如时间管理或是組織化建議。自我控制的課程似乎幫助不大。

多管齊下

ADHD的多元介入治療包含藥物治療、親職諮商訓練、學校資源教育及社交技巧訓練等各種模式，這些治療模式的效果都有嚴謹而完整的科學研究加以證實[9]。藥物包括中樞神經刺激劑、阿托莫西汀、α2腎上腺素受體（英语：alpha-2 adrenergic receptor）刺激劑，有時也會使用抗憂鬱藥物[10][11]。治療用的中樞神經刺激劑可以提昇ADHD兒童的持續力以及任務表現[12][13]。

國立臺灣大學醫學院醫師高淑芬強調及早發現並接受治療，絕對是最佳策略。[14][15] 本身也是注意力不足過動症患者的愛德華·哈洛威爾醫師則建議治療的策略應把握發揚優點、避免缺點的原則。[16] 藥物治療合併行為治療（認知行為治療[17]）已證實為當前最有效的注意力不足過動症治療方式。[18][19][20][21][22][22][23][24]

台灣兒童青少年精神醫學會指出：「治療ADHD核心症狀時，藥物是絕對不能忽略的治療選項。[20]」台灣兒童青少年精神醫學會另指出，對於18歲後才獲得第一次ADHD診斷的患者，台灣健保僅給付短效中樞神經刺激劑（利他能），但患者若認為有使用其他長效中樞神經刺激劑或者長效型非中樞神經刺激劑藥物的需求，應勇於跟醫生討論，不要因而忌諱就醫，延誤治療時機。[25][15]:105

研究顯示，ADHD的藥物治療能顯著降低患者發生交通事故的機率。[26] 研究也顯示，ADHD的治療可能大幅降低ADHD患者被霸凌或霸凌他人的機率[27][28][29][30]（包含遭受網路霸凌或在網路上霸凌別人[31][32]）。[33][34]

非藥物治療

行為治療

父母管理訓練前（before）後（after）的效果对比[35][36]

行為治療被認為是對注意力不足過動症孩子進行行為介入具有實證性效果的方法。透過系統化的行為分析，了解孩子犯錯的模式，並且配合後果增強與削弱的方法，以及教導他正確的行為模式，例如：懂得等待、輪流等觀念，減少他衝動、過動而引起的人際衝突、人際互動的情緒調節（英语：interpersonal emotion regulation）、情緒管理（英语：Emotional_self-regulation）。

專攻注意力不足過動症的認知行為治療，對於治療年紀接近或已經是成人的注意力不足過動症患者來說是有效的。（例如：憤怒管理、時間管理、改善包括記憶力、計畫及執行能力、自我啟發能力、自我體察（英语：Self-monitoring）在內的執行功能等。）[37][38][39]

許多ADHD支持團體的存在得以作為許多家庭的正確治療資訊來源而且能協助家庭一起管理ADHD。[40]

對於那些學齡前且僅有些微注意力不足過動症症狀的孩童，已建議「行為治療」為治療該族群的第一線療法。[41] [42] [43]

行為方面的治療 簡介
心理教育 以醫學實證為根據的療法，用以協助患者以及他的愛人了解疾病的資訊並提供支持，以便讓他們能更有效地面對一個疾病。[44][45][46]
行為治療 行为治疗家主张心理障碍中表现的异常行为如同正常行为一样是可以习得的，可以通过基本的条件作用原理（英语：Behaviorism#Operant conditioning）和学习原理而使心理障碍得到矫正的。[47][48]

此外，對於兒童來說，行為治療將協助孩子與其家長學習一些技巧：

  • 維持每天固定的行程與時間表。
  • 減少環境中可能的分心源。
  • 在特定的地方或符合邏輯的地方做相對應的事情，例如：在書房或自習室讀書、在遊戲間放置玩耍的玩具等。
  • 把大目標切成許多微小但較容易達成的小目標，分階段實行。
  • 獎勵正向的行為。（例如：使用累計點數的方法（英语：Token_economy），累積到一定的點數就能獲得獎勵。）
  • 分析看看有哪些可能平常不被注意到，但是卻暗中導致自己做出不適當行為的因素。
  • 利用統計圖表和打勾勾列表清單（英语：checklist）來幫助孩子把心神維持在一件事情上。
  • 不要給予太多選項供孩子選擇 （limiting choices）。
  • 與孩子一起發掘孩子的天賦所在。
  • 善用冷靜紀律（calm discipline），例如：時間暫停（英语：Time-out_(parenting)）、將孩子抽離事發現場、轉移孩子的注意力（distraction）。

[39]

認知行為治療 改變認知的方式，讓孩子們學會以不同的、新的正向想法，來取代原先錯誤的、舊有的負面想法。[49]

對於成人來說，認知行為治療將協助他們改善ADHD的核心症狀—執行功能不足：[註 1]

[38]

人際取向心理治療 人際取向的心理治療的中心思想是「既然人際關係和生活中的大小事能影響心情；那麼反過來，心情也能影響人際關係和生活中的大小事」。[53]
家庭治療（英语：Family therapy）（也稱：家族治療） 當前的證據表明「MTA模式的行為治療中的家族治療」的療效類似「普通精神科門診的照護（通常包含ADHD藥物治療）」且優於完全不治療ADHD。[54][55][56]
學校資源介入（英语：school-based interventions）
-
社交技巧訓練 學習與「非正涉入違法行為的年輕人和同儕」交朋友對於ADHD孩子來說十分重要，因為這能顯著降低往後人生可能出現的問題，例如：憂鬱症、犯罪、在學過程遇到的各種挫折和物質濫用的機率[57][58]。
運用同儕的行為干預（英语：behavioral peer intervention）
-
組織規劃能力與技巧的培養（英语：organization training）
-
生活管理能力與技巧的培養（英语：Daily living skills training）
-
父母管理訓練 父母管理訓練可能直接改善孩子的行為問題，例如：對立反抗的舉止或違抗指令的言行。 [59]環境的支持有利於注意力不足過動症的治療[60][61][62][63][64]。
團體心理治療 一群特定人們與治療師透過團體活動達成治療目標的一種心理治療。[65]
生理（神經、腦波）回饋（英语：Neurofeedback） 當前腦波回饋是否具有療效仍然未知。[66]
行為改變（英语：Behavior modification） 證據表明具有一定益處。[57]
語言治療 台灣的中央健保署自2014年起同意台灣的兒童青少年精神科醫師可以如同復健科醫師及「耳（英语：Otology）、鼻、喉科醫師」一般開立「語言治療」的處方。[67]
應用行為分析 先釐清行為與環境之間的交互作用關係後再協助行為改變。[68][69]
正念療法

正念療法尚需更多研究來證明其有效性。[38]

婚姻諮商 [70]
職業諮商（英语：Career_counseling） [70]
ADHD教練 [70]
更多信息：俄罗斯方块效应（英语：Tetris effect）、行為改變（英语：Behavior modification）、習慣反轉訓練（英语：Habit reversal training）、矛盾意向法（英语：Paradoxical intention）、固著 (心理學)、注意力不足過動症教練、共同行動模式、有關衝動的治療（英语：Impulsivity#Intervention）

目前對於精神疾患（包含注意力不足過動症患者）的治療方式是基於生物-心理-社會模式，良好的精神治療模式必須結合生物醫學、心理治療，以及社會復健計畫。[71][72][73][74][75][76]

藥物能幫助注意力不足過動症患者從生理上穩定情緒、增進專注力和組織規劃能力，降低不適當言行的出現。[15]

認知行為治療

著重在「常在成人患者身上觀察到的執行功能缺失」的認知行為治療，主要協助患者治療以下問題[77][78]：

  • 難以持續掌握任務和活動、難以對任務或活動抱持恆心。
  • 拖延。
  • 有分辨事情緩急輕重的困難。
  • 缺乏管理能力。
  • 做短期和長期計畫的能力不符合患者年齡該有的成熟度。[79]

美國國家心理健康機構（英语：NIMH）建議成人注意力不足過動症患者：

  • 依照事情的類別建立各自的行事曆。例如：家庭行事曆、工作行事曆、醫療行事曆等。[80]

青少年及成年

《找回專注力：成人ADHD全方位自助手冊》一書中指出，對於年紀稍長的注意力不足過動症患者來說，要習得正向的情緒表達方法和社交技巧並養成良好規律且有秩序的生活習慣則有賴患者身體力行，善用認知行為治療的原理。「認知行為治療」分為「認知治療」和「行為治療」兩部分。[15]

認知治療包含：心理建設、正面回饋、衛教、和思考練習來建立正確的觀念和健康的態度、激發改變的動機、鼓舞自信和提升勇氣，遠離負面思考。 行為治療是運用「刺激-反應」的原理，把一個大目標切成許多小目標，並加上正面的酬賞作為鼓勵，幫助患者一步一步的接近小目標，一次又一次的完成小目標，整個大目標即隨之而成。 成功完成某階段的目標後，便可適度提高挑戰性，例如：從「持續做一件事達15分鐘」變成「持續做一件事達30分鐘」以此類推，逐步建立起良好的習慣。最後就可以順利達成連續做一件事情達一個小時的願景[15]。除此之外增加「環境結構」[註 2]、學習分辨事情的緩急輕重[16]、學習「改善ADHD症狀的實用技巧與策略」[註 3]也是行為治療的主軸，然後再輔以其他行為治療的方式。（其他的行為治療方式並非不重要）

[81]

兒童

《家有過動兒：幫助ADHD孩子快樂成長》一書中指出，對於年紀輕輕的小孩來說，由於自我能力有限，因此行為治療以「課堂上的行為治療」及「家中的行為治療」為主，其他的行為治療方式為輔。（其他的行為治療方式並非不重要） [49][82] 書中並建議「讓孩子承擔適度的責任」，孩子表現出來的態度往往令人驚喜。[49]:133-134

學校

《家有過動兒：幫助ADHD孩子快樂成長》一書中指出，學校老師可以多提供「正向動機」，包含：課前提醒和課堂中的鼓勵。而在孩子的座位安排上盡可能減少能讓他/她分心的誘因。允許孩子把作業分批次寫完並在課堂上保留小組討論的時間、與孩子共同討論規範與自由[49]。

課堂外的策略：

  1. 協助孩子找出在特定情境下出現的問題。[49]
  2. 找出孩子正確的行為。譬如說：需要排隊時，他可以乖乖地待在隊伍中；或者先讓孩子在一旁做別的事，等到快輪到孩子時，再來排隊。[49]
  3. 在教師訓練中選擇有教授ADHD相關知識和行為訓練的技巧的課程。[49]
  4. 靈活應用「獎勵制度」及「正增強」來鼓勵、鼓舞孩子的正向行為。[49]
  5. 與孩子一起找出問題是什麼、該怎麼解決、有哪些好方法、這些好方法中哪個方法「可能」是最好的、實際做做看、實驗結果分析探討。[49]

家庭

參見：父母管理訓練、親子關係、教養方式及親子對立（英语：Parent–offspring_conflict）

《家有過動兒：幫助ADHD孩子快樂成長》一書中指出，ADHD的孩子無論在校內或校外常屬於弱勢的一群，容易被誤會。回家後又容易因為粗心大意挨罵[83]。ADHD孩子與一般孩子一樣努力，想要有好表現，得到讚美；但卻事與願違，他們常常失敗，長期缺乏肯定與成就感。因此容易因情緒壓力而衍生出其他共病。[49] 父母與孩子溝通，彼此交換想法的過程，當如平時一般，心平氣和。憤怒會阻礙親子之間的溝通。[49][84]

在台灣，有兒童心智科醫師在從事注意力不足過動症（ADHD）的臨床醫療過程中發現，照護ADHD的核心困難之一乃ADHD孩子的照護需要其照顧者投注長期的心力，然而通常作為ADHD孩子照護者的孩子父母又往往因為孩子的ADHD症狀對其家庭生活及學校生活所造成的負面影響而有長期負擔，此情形下，不容易長期提供有ADHD的孩子完善的照顧。醫療團隊於是建立以醫療專業、家庭兩者為互動主體，互相灌注支持能量並攜手成長的長期照護模式，並稱之為「共同行動模式」[85][86][87]。

家中的行為治療

參見：父母管理訓練、忽視（英语：Neglect）、被忽視的孩子（英语：Child_neglect）、虐待兒童、自我忽視及家庭暴力
*治療師會定期與家庭成員會晤以觀察進度並提供持續的支持（左對話框）。
  • 在會晤中，家長現場實習從治療師那學來的技巧（右對話框）。
  • 即便療程結束，家庭成員仍能持續感受到行為的改善以及壓力的減輕（下方橫幅）。[88]
家長能在行為治療中學到的三種核心能力
家長能在行為治療中學到三種核心能力：正向溝通、正向激勵/強化（英语：Reinforcement#Positive_reinforcement）、結構與一致的紀律/規範/規則[88]

在行为治疗期间，治療師會定期與家庭成員會晤以觀察進度並提供持續的支持[註 4]。在會晤中，家長現場實習從治療師那學來的技巧，即便療程結束，家庭成員仍能持續感受到行為的改善以及壓力的減輕。[88]家長能在父母教育訓練中學到三種核心能力：正向溝通、正向激勵/強化（英语：Reinforcement#Positive_reinforcement）、結構與一致的紀律/規範/規則[88]。

  • 用「愛」來溝通
  • 傾聽與陪伴[92]
「父母教育方式與ADHD孩子說謊」之間的關係

任職於奇美醫院的獎斐忠政醫師表示，大人常給了ADHD孩子不切實際的要求，例如：受到注意力不足干擾的孩子，本來寫作業就可能需要較多的時間，此時大人如果沒有考慮到小朋友能力上的限制，不從根本去做調整，只是要求結果，命令孩子在半小時後上床躺平，否則就要處罰。在這樣不合理要求的情況下，要小朋友不說謊，就非常困難。[93]

獎斐忠政表示，了解ADHD孩子每次說謊背後的需求、ADHD對他所造成的困難、以及孩子說謊背後的動機，並且撇開道德、個性的審判，從根本的方面去思考探討，下次就可以用更好的方式解決問題。[93]

正念療法

2018年4月出爐的最新文獻顯示，「認知行為治療+藥物治療+正念療法」的策略比「認知行為治療+藥物治療」帶給患者更大的進步，因此有成為未來正式治療策略的潛力。[94] 然而單獨就「認知行為治療」和「正念療法」相比，未服藥且單獨接受「認知行為治療」或「正念療法」的ADHD患者經過訓練後，並未發現「認知行為治療」和「正念療法」的療效有何差異。[95] 有鑑於前述不一致的實驗結果，正念療法尚需更多研究來證明其有效性。 [38]

體外三叉神經微電流刺激系統

體外三叉神經刺激系統（external Trigeminal Nerve Stimulation System，簡稱eTNS）是在體外利用電流刺激三叉神經的設備。[96]

2019年4月，美國食品藥物管理局（USFDA）批准用此設備治療美國7-12歲之未使用藥物治療ADHD的患者，是美國首度核准的第一項ADHD醫療器材，僅限醫師處方。eTNS可以做為ADHD的單獨 療法，亦即不必搭配其他的ADHD藥物或是非藥物治療。[96] ADHD孩子在晚上睡覺的時候，在其照顧者的督導下，將eTNS貼在額頭表皮，以利eTNS傳送微弱的電流刺激孩子的前額葉，此時孩子會感覺到頭皮麻麻的。[96] 照顧者須確保孩子在接受eTNS治療的時候，周遭無任何無線電磁波和微小電流的干擾（例如：手機、心跳速率調節器等）。[96] ADHD孩子可能需使用eTNS連續四周才能出現療效，之後才回診接受醫師的療效評估。[96] 在USFDA核准eTNS為ADHD的正式療法前，研究人員曾安排62名中重度的注意力不足過動症兒童患者，於每天晚上睡前在額頭貼上eTNS微弱電流貼片，起床後拿掉。就這樣連續一個月後，研究人員發現，62名患者中，使用真實的 eTNS微弱電流貼片者，其ADHD-RS分數從34.1分降到23.4分（ADHD-RS分數越高，代表ADHD的症狀越強烈），相較之下，那些不知情的狀況下使用不真實的 eTNS微弱電流貼片者，其ADHD-RS分數從33.7 降到 27.5分。[96]

常見的eTNS的副作用為：疲倦、食慾增加、睡不好、磨牙（teeth clenching）、頭痛、與倦怠。然而其程度都十分輕微，不到「失眠、食慾增加、睡不好、磨牙、......」的正式診斷標準。其他較少見的eTNS之副作用，沒有任何項目被USFDA評定屬於嚴重或危險等級的。[96][97][98]

對此，有些在醫療現場直接面對患者（臨床）的兒童與青少年精神科醫師（兒童心智科醫師）持保留態度，認為該雙盲随机对照试验中的參與者（樣本數）僅62人，因此覺得須留待日後更多的文獻證明eTNS的療效。[99]

藥物治療

      參見：ADHD的治療藥物、藥品一覽表

2011年，全美「有ADHD診斷的兒童與青少年（4-17歲）且被診斷數年後至少仍符合ADHD診斷最低標準的患者」之用藥比例。 [100][101][註 5]

  正在接受藥物治療者（69.3%）
  沒有正在接受藥物治療者（30.7%）

2016年，全台灣「有ADHD的兒童與青少年（4-17歲）」之用藥比例。 [102][103][104][105][106]

  正在接受藥物治療者（4.8%）
  沒有正在接受藥物治療者（95.2%）

藥物可以減少「過動—衝動」、分心等核心症狀，提升孩子的自制力，讓他們有足夠的能力追尋自己的夢想。另外一方面，藥物是治療腦部先天性功能缺陷。在醫療用途上，ADHD藥物的副作用均輕微，副作用透過調整藥物配方（停藥、減少劑量、加入Clonidine等緩心悸藥物）即可改善。在醫學與藥學（藥理學、藥劑學）知識的把關下，中樞神經刺激劑等藥物都是安全的。

ADHD有時可能出現忘記吃藥的情形[註 6]，且短效藥物在血漿內的濃度變化很快，故不易維持穩定的療效，所以中長效型的藥物，對於患者來說是較為適合的。[108][109] 除此之外，中樞神經刺激劑的劑量如果不足，會導致「治療ADHD的療效打折」或「藥效只出現一下下（later loss of effectiveness）」[110]。中樞神經刺激劑的劑量不足的情況曾經發生在成人及青少年患者身上且未來也有可能發生，因為美國食品藥物管理局批准的劑量主要是適用於學齡兒童。為此，有些臨床醫師選擇改以體重或臨床療效（英语：clinical judgement）作為處方藥物的劑量的基準。[111][112][113][114]

「中樞神經刺激劑」[註 7]被列為第三級別『管制藥品』的原因在於避免民眾尚未經醫師處方就錯誤地使用[115]。

管制藥品雖具有醫療用途，但也可能因不當流用、濫用後而導致成癮，為了使管制藥品不致於淪為非法毒品，台灣的《管制藥品管理條例》規定，醫師必須領有管制藥品使用執照，才能開立第1~3級管制藥品專用處方箋；而藥師也必須依「管制藥品專用處方箋」才可調劑此類藥品；除此之外，患者領藥時，必須出具身分證明，並在專用處方箋上簽名，確保用藥安全[116]。而患者領藥後應依據醫師開立的管制藥品處方箋，遵循醫囑，正確地服用[116]。如果管制藥品不是由醫師診斷、開立，甚至來路不明，民眾切勿服用，以免無法改善病情，還可能上癮或造成更嚴重的傷害[116]。

雖然個案可能常看似已興奮過頭，且治療藥物被歸納為興奮劑類[註 8]，但是興奮劑類藥物確實有幫助患者們保持平靜的效果。[117] 每個人或多或少都會有分心、過動或衝動等症狀，但這些症狀在ADHD患者上會更為頻繁的出現、症狀的嚴重度更高且影響生活、學業、工作等。一個現象是否達到疾病等級，必須考量到頻率及程度。[118]

有些家長或孩童會以為使用藥物即可解決相關問題，因此對於藥物過度依賴，卻忽略需配合藥物使用的時期，讓孩子學習與接受指導，建立起人際互動、行為管理等技巧。這也讓孩子有機會可以不靠藥物自我管理。[119][120]

一般來說，以藥物治療ADHD的效果相當顯著。 [18] [21] 使用此類藥品的患者，長期治療的預後，幾乎都可以改善其注意力不集中、衝動與人際衝突的症狀；而且患者的社會性互動及人際關係乃至閱讀能力（英语：reading comprehension）也都會有改善。[18][121] 文獻另指出，針對ADHD的個人化醫療可能包含較新的ADHD藥物配方、組合。[122]醫師藉由藥劑量滴定（英语：Dosing）協助病人找到對病人來說最適合、最有效的藥物劑量（英语：Dose (biochemistry)）[123]，而不同的ADHD子類型所適用的最小有效劑量（英语：Effective_dose_(pharmacology)）可能不同[124]。

近年來，多項國際大型研究表明適當的注意力不足過動症藥物治療可以減少未來意外傷害、交通事故的機會、降低頭部外傷的風險並且減少物質使用和濫用的機率。[20] [125] [126] [127] [128] [129] [130] [131][132][133][26]

PloS One期刊中一篇文獻指出，對臨床醫師而言，應向患者及家屬傳達「持續藥物治療對於減少身體傷害有其重要性」。研究發現，相較於從未接受藥物治療的患者，接受藥物治療超過180天的ADHD族群，其骨折風險顯著較低，低了將近23%。有接受藥物治療，但總期間不超過180天的患者，其骨折風險與未接受藥物的族群比較起來並無明顯差異，凸顯了藥物治療持續時間的影響。[125]

台灣兒童青少年精神醫學會指出：「治療ADHD核心症狀時，藥物是絕對不能忽略的治療選項。[20]」台灣兒童青少年精神醫學會理事長高淑芬另指出，對於18歲後才獲得第一次ADHD診斷的患者，台灣健保僅給付短效利他能，但患者若認為有使用其他藥物需求，應勇於跟醫生討論，不要因而忌諱就醫。[134][15]

ADHD藥物治療能減少ADHD患者（無論是否被診斷出來）身體受傷的發生率[135]

中樞神經刺激劑

参见：苯丙胺 § 醫療

中樞神經刺激劑藥物是治療ADHD的藥物選擇之一。[136][137] 中樞神經刺激劑至少能在14個月內，改善部分ADHD的症狀。[138][139][140]

一些家長和老師回報哌甲酯似乎能改善ADHD的症狀。[139][138][141] 中樞神經刺激劑似乎也能降低ADHD遭遇意外事故傷害的風險。[142]核磁共振成像學研究表明長期以安非他命或哌甲酯能降低ADHD患者腦部中的結構和功能的異常。[143][144][145] 一篇2018年的系統性回顧發現以哌甲酯治療兒童、以安非他命治療成人能帶給他們最大的短期療效。[146] 中樞神經刺激劑必須定期暫停使用或降低藥劑量以評估ADHD患者是否還需要繼續用藥、即便ADHD患者仍需要繼續用藥，定期暫停使用或降低藥劑量的作法能降低患者可能身高發展延遲和腦部神經開始習慣藥劑量（耐受性）的風險。[147][148] 長期以「遠高於治療用劑量」的中樞神經刺激劑治療ADHD，可能會導致成癮和物質依賴。[149][150] 然而，若ADHD未被妥善治療，患者在往後容易出現物質濫用和行為問題（英语：conduct disorders）的風險。[149] 使用中樞神經刺激劑治療ADHD，至少能不同程度的降低這些風險。[151][152][149]

治療注意力不足過動症的第一线药物为中樞神經刺激劑（又名為中樞神經興奮劑，簡稱為兴奋剂），其中包括[153]：

藥物名 藥物（主成分/有效成分）學名 作用時間 生效時間 備註
利他能（Ritalin） 哌甲酯[註 9] 短：3.5小時左右 約服用後30分鐘
Adderall 右旋苯丙胺和左旋苯丙胺
  • 短效型：4-5小時[158]
  • 長效型：10-12小時[158]
  • 短效型：30-60分鐘[158]
  • 長效型：60-90分鐘或更短[158]
Desoxyn 甲基苯丙胺 N/A N/A
Tyvense 甲磺酸赖氨酸安非他命 12小時 2 小時
Dexedrine 右旋安非他命
  • 立即釋放型：3-7小時
  • 長效型：12小時
  • 立即釋放型：0.5-1.5小時
  • 長效型：1.5-2小時
利他(長)能LA
（Ritalin LA/利長能）		 哌甲酯 中：8小時左右 約服用後30分鐘
專思達/專注達 哌甲酯 長：12小時左右 約服用後30分鐘

[15] [164] [165] [166] [167]

  • 必須避免於藥物作用期間攝取乙醇和醇，因為這兩種物質很可能會導致血漿中的methylphenidate濃度急速升高[154]。

利他能[167]、利長能[164]、專思達[166]、安保美喜錠[168] ，所含之有效成分皆為哌甲酯，各自在藥效動力學上具有相同屬性；在藥物代謝動力學上的作用則有些微差異。[169][170][171]醫師可依患者的需求，視各種藥品之藥物動力學的特性，調整處方藥物，實現個人化醫療[172] 常見的專思達，其12歲以下的使用者每日最大劑量上限為54毫克；13到17歲的使用者之每日建議 最大劑量上限為72毫克[173][174]。若患者早上服用的中長效劑型藥物之藥效在傍晚開始消退，患者可視需要再服用短效劑型藥物，彌補隨著長效型藥物藥效退去後產生的療效落差。[49][175][176]:722[175]

雖中樞神經刺激劑藥效約於服用後半小時左右開始，並不表示症狀會在服用後半小時就消失，如同其他疾病的治療一樣，病情的改善需要一定（段）時間的持續治療（時間長度因人而異）。藥物（包含：中樞神經刺激劑、非中樞神經刺激劑、......）會在這些患者的背後推他們一把，助他們一臂之力[19]。然而，即便如此，患者本身仍需認真努力地改變自己。藥物是注意力不足過動症整體治療的其中一環。[15][16][177]

根據世界反運動禁藥組織，中樞神經刺激劑在未事先申請醫療許可及非醫療所需的情況下服用都將被視同違規行為。[178]

部分用來治療注意力不足過動症的藥品（例如：中樞神經刺激劑）在美国食品藥物管理局划分为二级管制藥品（Schedule II，即指有滥用可能性的药品），在台灣則列為第三級管制藥品。[126][179][180][181]

中樞神經刺激劑即便正確依照藥物動力學及藥效動力學知識下使用，仍強烈 建議用藥者應定期追蹤自己的體重、心跳與血壓等[註 10][182][183][184]，研究顯示中樞神經刺激劑造成的心血管作用與其攝取劑量多寡有關[184][185]（中樞神經刺激劑可能產生的副作用有：食慾降低、雷诺氏综合征、心跳與血壓上升等；高血壓可能不會被人覺察到，然而血壓長期超越正常範圍可能會導致許多健康問題；食慾降低可能不自覺地引起低血糖，導致心悸等副作用[186][187]；食欲降低也可能讓服藥者在空腹的時候卻不覺得餓，使得其三餐未定時定量，再者，中樞神經刺激劑本身會刺激胃酸分泌，多重因素交織，長期下來，容易引起腸道不適（英语：Abdominal_distension）或胃潰瘍[188]）。[189][182][190][191][192][193][194][195][196][197]

患者第一次用藥前必須先進行全面的心血管功能檢查，以確保患者沒有重度的先天性心臟病或存有任何嚴重的心血管問題。[182][182][198]有研究指出ADHD用藥可能會引起血管硬化，然而尚需更多研究確認，並且也要再確認此現象是否有到臨床上界定需要治療的程度[199][200][201][202][203]。

中樞神經刺激劑藥物可能的副作用包含口乾、失眠、急躁/急性子/靜不下來、煩躁、食慾降低、基礎代謝率增加[註 11]、體重下降、頭痛、抖動、抽动综合症、尿液滯留[註 12]等[204][205][206][207][208][註 13][209] [210][211]；而在不超量使用中樞神經刺激劑藥物的情況下，其引發幻覺、偏執、心血管問題等嚴重副作用的機率極低，大約千分之一到萬分之一，而且發生的機率和沒有服用藥物的人沒有差異。[182][212][213][214][212][213][215] 因此期刊整理過去 185個研究（達一萬兩千多人），得到的研究結論是：注意力不足過動症的治療藥物並未增加嚴重副作用風險的機會。相對而言，常被家長忽略的是，限制或延遲患有ADHD的兒童及早接受有效的治療可能導致往後出現的嚴重後果，例如顯著 增加孩子在其青少年時期衍生物質濫用、中途輟學、學業挫敗（academic failure）、意外事故等風險[132]（陳錦宏醫師指出，發生意外及藥物成癮或酒精成癮的風險約達到50%）[106]。[註 14][217]不過考科藍協作組織於2015年發表的系統性文獻回顧指出，使用中樞神經刺激劑後，像失眠、食慾不振等較不嚴重的副作用常出現在服用者身上，並衍生出長期預後的不確定因素[218]。

所有用來治療注意力不足過動症的藥物只要依照醫師基於藥物動力學及藥效動力學所做成的醫囑用藥，都是相當安全的。[126][179] [219] 而藥物成分為哌甲酯的中樞神經刺激劑，例如：利他能與專思達，可能導致：心悸、頭痛、胃痛、喪失食慾、失眠、因相對專注而變得冷淡（面無表情）等副作用，因此6歲以下的兒童不適宜將藥物當成第一線療法服用。（副作用產生與否因人而異） [220]

隨著時間推進與各方的努力，中樞神經刺激劑的相關副作用[註 15][註 16]已可藉由包括但不限於劑量調整、服藥時間、飯前飯後服用、服藥頻率等服藥模式之改變以及改變藥物組合等方式獲得相當程度的減少。[126] [221] [222] [223] [224] [225][226][227]

UpToDate指出，使用者於中斷使用中樞神經刺激劑後恢復使用之，可能需要重新從較低的劑量開始逐步增加至理想劑量。[228][229]

近年來美國正值可受孕期的女性（15-44歲）服用中樞神經刺激劑治療成人注意力不足過動症的人數大幅增加，截至2015年此類女性已佔全美國女性的4%[230]。然而研究初步發現，胎兒在子宮接觸到哌甲酯，有相對控制組來說，較高的風險在出生後帶有先天性心臟病，而安非他命則無此風險。[156]因此當醫生處方哌甲酯給孕婦（包含不知自己已經懷孕的女性）前，應該權衡此舉對患者的利弊得失。[156]

食物可能延遲Adderal XR的生效時間並增加安非他命在血漿中的最高濃度；Concerta 則無此特性[231]。

  關於更多中樞神經刺激劑和其藥物，請見中樞神經刺激劑、哌甲酯、和安非他命尤其安非他命§醫療乙節。
右旋安非他命
禮來公司思銳60毫克膠囊（Lilly Strattera 60mg Capsule）
思銳（Strattera）外盒

第一線中樞神經刺激劑

專思達（Concerta）仿單（說明書）上的建議劑量
患者年紀 建議起始劑量 建議劑量範圍
6-12歲 18 毫克/每天 （mg/Kg） 18 - 54 毫克/每天 （mg/Kg）
13-17歲 18 毫克/每天 18 - 72 毫克/每天 每天每公斤不可超過2毫克。[註 17]
18-65歲 18 或 36 毫克/每天 18 - 72 毫克/每天 （藥物臨床試驗（英语：clinical studies）中記載的安全（英语：Therapeutic_index#Maximum_tolerated_dose）且有效的劑量範圍（英语：Effective_dose_(pharmacology)）為：36 - 108 毫克/每天 [232]）

[233] 註解：

  1. 在專思達的藥物試驗過程中發現，13-17歲的青年試驗組中，專思達的最低有效劑量為： 每天每公斤1.4毫克 (1.4 mg/kg/day)。[233]
  2. 18歲以上的兩個成人試驗組中，發現每天18-72毫克的劑量皆可達到在統計學上具顯著意義的療效。（然而以每天36毫克以上進而達到統計學上具顯著意義的療效的臨床試驗者為大多數。）[234]

至今為止的「藥劑量最佳化（Dose-optimization）」的成人組臨床試驗揭示：成分為methylphenidate的藥品，無論為短效或長效，每日最高的上限劑量總和為120毫克（120 mg / day）[235][236][237][238]。

非中樞神經刺激劑

數種非中樞神經刺激劑，例如：阿托莫西汀、可樂定、安非他酮和胍法辛，可與中樞神經刺激劑一起使用，也可以作為中樞神經刺激劑的替代方案。[136][140][239] 當前並無高品質的文獻比較過這些藥物的優劣，然而這些非中樞神經刺激劑藥物之間的副作用似乎大同小異。[240] 中樞神經刺激劑似乎能改善用藥者的學業表現，阿托莫西汀則否。[241] 阿托莫西汀，受惠於自身對於用藥者的成癮性或依賴性較低的屬性，所以適用於使用於那些有極高可能把中樞神經刺激劑用於娛樂用途或因為衝動而大量用藥使得中樞神經刺激劑的劑量遠高於醫療用劑量的患者。[151] 當前有些許證據表明這些藥物能改善患者的社交行為能力。[240] 截至2015年6月 (2015-06)，ADHD藥物的長期療效尚未被完全評定。[152][242]

禮來公司（Eli Lilly）的思銳（Strattera），有效成份為阿托莫西汀[243]，與中樞神經刺激劑同樣為治療ADHD的第一線藥物。思銳為非中樞神經刺激藥物（非興奮劑），且歸類於選擇性正腎上腺素再回收抑制劑。思銳有六種劑量型，分別為：18MG、25MG、40MG、60MG、80MG和100MG。[243] 「對於年齡小於18歲且體重小於70公斤」的使用者來說「總計每天服用劑量的上限為每公斤1.4 毫克（mg/day）」；對於「年齡大於或等於18歲或年齡小於18歲且體重大於70公斤」的使用者來說「總計每天服用劑量的上限為每天100毫克（mg/day）」。[244]

思銳的副作用相較於中樞神經刺激劑來得輕微許多。思銳主要的副作用有：疲倦、口乾（唾液分泌減少）等[243]。（副作用產生與否因人而異）[243]患者如果對中樞神經刺激劑沒有反應、反應不佳或過敏，可考慮使用阿托莫西汀。患者可向醫生詢問，共同制定一個漸進的劑量法。

思銳的藥效可以持續24小時[245]。思銳從第一天服用開始約需持續服用28至56天（4週到8週）才會完全生效。[246][247] 然而患者或患者周遭的人在這期間便可能逐漸感受到藥效 [248] [249][250][251]。服用者建議定期追蹤監測心律、血壓、肝功能（英语：liver function）[252]，患者第一次用藥前建議先進行全面的心血管功能檢查，以確保患者沒有先天性心臟病或存有任何嚴重的心血管問題[252]。

縱然阿托莫西汀與中樞神經刺激劑同樣為治療ADHD的第一線藥物，然而其對特定症狀改善的程度可能與中樞神經刺激劑不同（兩類藥物各有其長處）。阿托莫西汀在改善「過動-衝動」的症狀上，略優於派甲酯；派甲酯則在改善「分心」的症狀上，略優於阿托莫西汀。[253][254] [255] [256] [257]

而阿托莫西汀與哌甲酯併服的處方尚未經美國食品藥物管理局核可，但醫師會視個案的情況（如共病、預後等）以開仿單標示外使用的方式處方之。[258][259][260][261][262][263]在臨床試驗中，並未發現兩者併服後產生加乘的心血管副作用。換言之，兩者併服之心血管作用，與單獨服用哌甲酯所產生的心血管作用相同。[264]

可樂定與胍法新（英语：guanfacine）皆為非中樞神經刺激劑、α2腎上腺素受體（英语：alpha-2 adrenergic receptor）刺激劑/促進劑/活化劑 的一員；與哌甲酯併用或單獨服用都有顯著療效，其中兩藥物併服：可樂定或胍法新與哌甲酯或安非他命合併使用的療效優於單獨服用任意一者。[註 18] [221] [265] [266] [267] [268] [269]

請注意：

  1. 美國食品藥物管理局已證明數起曾因為併服：可樂定、胍法新、哌甲酯或安非他命而致命的個案群與四种药物本身並無關聯。[270]
  2. 《美國兒童青少年精神醫學會期刊（英语：Journal of the American Academy of Child and Adolescent Psychiatry）》所刊登之論文，「可樂定或胍法新與哌甲酯或安非他命合併使用的療效優於單獨服用任意一者」的結論是立基於使用「長效可樂定或胍法新」作為臨床實驗過程中的試驗物。[221][265][267][268]
藥品學名 藥物類別（屬性） 作用時間 備註
阿托莫西汀 （思銳）[註 19] 選擇性正腎上腺素再回收抑制劑、非中樞神經刺激劑（非興奮劑） 5.2小時 [251][272][273][274]
  • 美國食品藥物管理局已經批准用於治療兒童、青少年及成人患者[120]。
可樂定 [註 20] alpha 2 腎上腺素受體刺激劑/促進劑/激動劑/激活劑/活化劑、非中樞神經刺激劑（非興奮劑） 2-4 小時 [276][277][278][279][280]
胍法新（英语：guanfacine） alpha 2 腎上腺素受體刺激劑/促進劑/激動劑/激活劑/活化劑、非中樞神經刺激劑（非興奮劑） 4-8 小時[276][284]
  • 已經可在中國大陸取得。[285]

選擇性血清素再回收抑制劑、選擇性血清素及正腎上腺素再回收抑制劑（SSNRI, Selective Serotonin and Norepinephrine Reuptake Inhibitor）等俗稱抗憂鬱劑的介入可能對於某些個案病情的改善亦有幫助。[10] [286][287]

安非他酮（國際非專利藥品名稱：Bupropion[註 21]）是菸鹼拮抗劑和較微弱的去甲腎上腺素-多巴胺再吸收抑制劑：一种主要作为抗抑郁药和戒烟药使用的药物、也可用作治療注意力不足過動症的第二線藥品與中樞神經刺激劑合併使用，或作為中樞神經刺激劑的替代方案。[136] [288] [289] [290] [291]

第一線非中樞神經刺激劑

思銳（Strattera）仿單上的建議劑量[243]
體重 每天服用的起始劑量 總計每天服用的目標劑量 總計每天服用劑量的安全上限
年齡小於18歲且體重小於70公斤 0.5 毫克/每公斤（mg/Kg） 1.2 毫克/每公斤 1.4 毫克/每公斤
年齡大於或等於18歲或年齡小於18歲且體重大於70公斤 40 毫克/天（mg/day） 80 毫克/天 100 毫克/天
（臨床試驗的劑量範圍為60 mg/day 到 120 mg/day[292]）
  • 備註：
  1. 建議劑量與種族無關。[243]
  2. 肝腎功能不全的患者的服用劑量應低於建議劑量[243]（詳見：阿托莫西汀§劑量）
  3. 總計每天服用劑量的上限 = 無論分幾次服用，一天之內最多可攝取的劑量。
  4. 每天的起始劑量應服用至少三天，使身體適應後，才可開始服用每天的目標劑量。[243]
  5. 若每天目標劑量效果不符預期，則可逐漸增加劑量至每天服用劑量的上限[244]

研究中藥物

成本－療效比較

若考慮注意力不足過動症治療的療效，效果最好的是結合藥物治療以及行為治療的方法，其次是只用藥物治療，再者是行為治療[293]。若同時考慮成本及療效，首先會考慮純藥物的治療、其次是行為治療，再者是結合藥物治療以及行為治療的方法[293]。以個人而言，最有效以及療效－成本比（cost-effective）最好的是用中樞神經刺激劑的藥物治療，長效性藥物的療效－成本比會比短效性的藥物要好[294]共病（二個疾病同時出現，例如重度抑郁症及ADHD）會使診斷及治療的成本更高。

其他治療方式

有時會用咖啡因來治療ADHD

大部份的ADHD替代治療方式還沒有足夠的證據以佐證其療效，目前也還不建議使用[295][296]。就算考慮其中最好的實驗結果，其效果也只是類似安慰劑的效果[296]。

神經回饋

神經回饋（英语：Neurofeedback）（NF）是一種針對患有兒童、青少年或是成人的治療方式[297]。此療法會用電極來測量人腦所釋放的電能。當有beta波出現時會發出警告，此理論認為罹患ADHD的人可以透過訓練來降低ADHD的症狀[來源請求]。

目前還沒看到神經回饋療法有造成嚴重的不良反應[298]，有關神經回饋的研究，目前還沒有高品質的成果[298]。目前有些有關神經回饋成效的資訊，不過說服力還不足：不少研究有正面的結果，不過設計的最好的實驗無法看出其成效，或是成效較弱[與來源不符][298][299]。在大部份的雙盲實驗中，看不出神經回饋的效果，因此正面效果也有可能是類似心理作用的安慰劑效應[300]。

飲食

主条目：飲食與注意力不足過動症的關係

健康及營養均衡的飲食（食物、飲用水及飲料）是保持身心健康的基礎，從而減少疾病（例如：慢性病）的生成。[301][302][303]

截至2019年7月，沒有任何科學證據顯示糖、或甜食（包括：糖分含量遠高於一般菜餚的食物）會影響人類的行為或導致ADHD[304] [305]<[306]。

飲食的調整可能對少部份的ADHD兒童有幫助[307]，一份2013年的統合分析針對有ADHD症狀，而且有補充游離脂肪酸或是減少食用有人工色素食品的兒童的相關研究發現，只有不到三分之一的兒童在症狀上有改善[308]，這方面的助益有可能只是對有食物敏感的兒童有幫助，也有可能是這些兒童同時也在接受ADHD的治療[308]，這些已發表的文獻也發現目前已有的證據無法支持減少食用特定食物來治療ADHD的療法[308]。2014年發表的文獻也發現排除饮食在治療ADHD上的成效有限[309]，另一篇在2016年發表的文獻指出，根據研究結果，「无麸质饮食在未來成為ADHD的標準療法」之機率是微乎其微[310]。

鐵、鎂及碘等礦物質的攝取可能可以改善ADHD的症狀[311]，有一些證據指出身體組織內的鋅成份過低和其ADHD症狀有關[312]，不過一般不建議用補充鋅礦物質的方式來治療ADHD，只有在有鋅缺乏的地區（幾乎只會在開發中國家）才建議補充鋅礦物質[313]。不過若鋅礦物質和苯丙胺類藥物同時使用的話，會減低苯丙胺藥物的最小有效劑量，也就是可以服用較少的藥物而達到相同的效果[314]。另有證據指出Omega3-脂肪酸能提供對於病情些許的改善[315][316]，不過也有證據指出其功效非常有限[317][318]，因此不建議用Omega3-脂肪酸來取代醫學治療[319] [320]。

一些研究發現，人工食用色素或防腐剂可能與少部分兒童出現類似ADHD的症狀，或者是與ADHD的流行率增加有關。[321][322]但是這些研究的證據力薄弱而且可能只適用於有食物不耐症的孩子。[322][308][323] 針對這樣的疑慮，英国和欧洲联盟已經發布相關食品管理措施。[324]

對於某些食物的食物過敏或食物不耐症，可能會惡化少數孩子既有的ADHD症狀。[309]

中醫

中華民國中醫師公會全國聯合會曾在2018年8月於臺灣召開記者會指出，「長久以來，傳統中醫在改善（ADHD）這類慢性長期精神生理疾病症狀方面，具有顯著的療效」[325][需要可靠醫學來源]。

中華民國中醫師公會全國聯合會另表示，2010 年發表於《Complementary Therapies in Medicine（英语：Complementary Therapies in Medicine）》[註 22]（一個替代醫學的期刊）的隨機雙盲對照試驗中提到，在頭部、背部膀胱經、足部腎經及足部肝經的進行針刺治療，有改善注意力不足與過動的症狀[326][需要可靠醫學來源]

運動

参见：體能鍛煉 § 與大腦神經元（腦功能）的關聯

適度且規律的運動，特別是有氧運動有助於改善許多中樞神經系統疾患的症狀，也證實為注意力不足過動症的有效附加療法（英语：add-on treatment）[註 23][15][16][37][327][328][329]。

長期規律的運動合併正規治療，將有更樂觀的預後（治療效果）-較好的行為以及運動協調性、大腦執行功能的提升（包含大腦認知領域中的：注意力、衝動克制力、和計畫組織的能力）、更快速的資訊處理速度、和更棒的記憶力。 [15][16][37][327][329]

統計由父母及教師填答的《孩子行為和社交情緒評量表》，結果顯示長期規律的有氧運動帶給孩子的效果是：身體所有功能的提升、ADHD的症狀減緩、焦慮和憂鬱的程度下降、身體症狀減少、較佳的課業及課堂中的表現、社交技巧進步。[327]

藥物治療合併規律的運動能放大中樞神經刺激劑作用於執行功能上的效果[327]。運動帶來的效果被認為是因為運動增加了腦中神經突觸間多巴胺和正腎上腺素的濃度[327]。

音樂

北美放射醫學會（英语：Radiological_Society_of_North_America）和有限的研究結果表示，音樂治療似乎有可能改善ADHD孩子在課堂上的表現[330]、增加注意力不足過動症及自閉症或亞斯伯格症（ASD）患者的腦部特定神經連結並使得預後更加樂觀[331]，然而音樂治療的有效性尚需更多相關論文支持[332][333]。

台灣精神科醫師高淑芬則表示，根據床經驗，讓ADHD患者聽音樂較能持續工作，也能增加效率，但高淑芬也說，若患者是聽有歌詞的歌曲或新歌可能就比較不適合，因為患者可能把注意力集中到音樂的歌詞上，沉浸在音樂中。[15]:117-118

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  51. ^ Barkley, Russell A.; Fischer, Mariellen. Predicting Impairment in Major Life Activities and Occupational Functioning in Hyperactive Children as Adults: Self-Reported Executive Function (EF) Deficits Versus EF Tests. Developmental neuropsychology (Informa UK Limited). 2011-01-31, 36 (2): 137–161. ISSN 8756-5641. PMID 21347918. doi:10.1080/87565641.2010.549877. 
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  53. ^ Markowitz, JC; Svartberg, M; Swartz, HA. Is IPT time-limited psychodynamic psychotherapy?. The Journal of Psychotherapy Practice and Research. 1998, 7 (3): 185–95. PMC 3330506 可免费查阅. PMID 9631340. 
  54. ^ Bjornstad G, Montgomery P. Bjornstad GJ , 编. Family therapy for attention-deficit disorder or attention-deficit/hyperactivity disorder in children and adolescents. Cochrane Database Syst Rev. 2005, (2): CD005042. PMID 15846741. doi:10.1002/14651858.CD005042.pub2. The findings from Jensen 1999 (N=579) indicate that no difference can be detected between the efficacy of behavioural family therapy and treatment as usual in the community. The finding from the available data from Horn 1991 slightly favours treatment over medication placebo. Further research examining the effectiveness of family therapy versus a no-treatment control condition is needed to determine whether family therapy is an effective intervention for children with ADHD. There were no results available from studies investigating forms of family therapy other than behavioural family therapy. 
  55. ^ Molina, Brooke S.G.; Hinshaw, Stephen P.; Swanson, James M.; Arnold, L. Eugene; Vitiello, Benedetto; Jensen, Peter S.; Epstein, Jeffery N.; Hoza, Betsy; Hechtman, Lily; Abikoff, Howard B.; Elliott, Glen R.; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Wells, Karen C.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan; Houck, Patricia R. The MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study. Journal of the American Academy of Child & Adolescent Psychiatry (Elsevier BV). 2009, 48 (5): 484–500. ISSN 0890-8567. PMC 3063150 可免费查阅. doi:10.1097/chi.0b013e31819c23d0. (b) multicomponent behavior therapy (Beh), which included 27-session group parent training supplemented with eight individual parent sessions, an 8-week summer treatment program, 12 weeks of classroom administered behavior therapy with a half-time aide and 10 teacher consultation sessions. 
  56. ^ NIMH » The Multimodal Treatment of Attention Deficit Hyperactivity Disorder Study (MTA):Questions and Answers. NIMH » Home. [2019-01-01]. Question: Why were the MTA medication treatments more effective than community treatments that also usually included medication? Answer: There were substantial differences in quality and intensity between the study-provided medication treatments and those provided in the community care group. During the first month of treatment, the MTA doctors worked hard to find the best dose of medication for each child receiving the MTA medication treatment. After this period, the children saw their MTA doctor monthly. 
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  64. ^ Chronis-Tuscano, Andrea; Wang, Christine H.; Woods, Kelsey E.; Strickland, Jennifer; Stein, Mark A. Parent ADHD and Evidence-Based Treatment for Their Children: Review and Directions for Future Research. Journal of abnormal child psychology (Springer Nature). 2016-12-26, 45 (3): 501–517. ISSN 0091-0627. PMC 5357146 可免费查阅. PMID 28025755. doi:10.1007/s10802-016-0238-5.  |year=与|date=不匹配 (帮助)
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  66. ^ Cortese, S; Ferrin, M; Brandeis, D; Holtmann, M; Aggensteiner, P; Daley, D; Santosh, P; Simonoff, E; Stevenson, J; Stringaris, A; Sonuga-Barke, EJ; European ADHD Guidelines Group, (EAGG). Neurofeedback for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and Neuropsychological Outcomes From Randomized Controlled Trials.. Journal of the American Academy of Child and Adolescent Psychiatry. 2016-06, 55 (6): 444–55. PMID 27238063. doi:10.1016/j.jaac.2016.03.007. 
  67. ^ 衛生福利部中央健保署 函. tscap.org.tw. 2014-02-11. （原始内容存档于2017-12-03）. 
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  69. ^ See also footnote number "(1)" of [and the whole "What is ABA?" section of] «Olive, Dr. Melissa. What is ABA?. Applied Behavioral Strategies. [2015-10-06]. （原始内容存档于2015-10-06）.  », where the same definition is given, (or quoted), and it credits (or mentions) both [i] the source "Baer, Wolf & Risley, 1968" and [ii] another source, called "Sulzer-Azaroff & Mayer, 1991"
  70. ^ 70.0 70.1 70.2 楊碧桃 教授. 成人 ADHD 患者之治療 (PDF). 國立屏東教育大學特殊教育學系 （國立屏東大學）. 屏師特殊教育（舊稱）. 2004-5, 8: 4-5 [2018-7-23]. （原始内容存档 (PDF)于2018-07-23）. 
  71. ^ 引证错误：没有为名为Haines Perkins Evans McCabe pp. 185–196的参考文献提供内容
  72. ^ 引证错误：没有为名为The College of Psychiatrists of Ireland的参考文献提供内容
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  74. ^ Recommendations - Attention deficit hyperactivity disorder: diagnosis and management - Guidance. NICE. 2018-03-14 [2019-08-19]. 
  75. ^ McGonnell, M; Corkum, P; McKinnon, M; MacPherson, M; Williams, T; Davidson, C; Jones, DB; Stephenson, D. Doing it Right: An Interdisciplinary Model for the Diagnosis of ADHD. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2009, 18 (4): 283–286. PMC 2765379 可免费查阅. PMID 19881936. 
  76. ^ Danciu, Elena Liliana. Multidisciplinary approach of the attention deficit hyperactivity disorder (ADHD) between hope and reality. Procedia - Social and Behavioral Sciences (Elsevier BV). 2011, 15: 2967–2971. ISSN 1877-0428. doi:10.1016/j.sbspro.2011.04.224. 
  77. ^ Safren, Steven. Mastering your adult ADHD : a cognitive-behavioral treatment program : therapist guide. New York: Oxford University Press. 2017. ISBN 978-0-19-023558-1. OCLC 983786200. 
  78. ^ Solanto, Mary. Cognitive-behavioral therapy for adult ADHD : targeting executive dysfunction. New York: Guilford Press. 2011. ISBN 978-1-4625-0963-8. OCLC 663954234. 
  79. ^ Author:Mary V Solanto, PhDSection Editor:David Brent, MDDeputy Editor:Richard Hermann, MD. Psychotherapy-for-adhd-in-adults. UpToDate. [2018-03-07]. （原始内容存档于2018-02-24）. 
  80. ^ NIMH » Attention Deficit Hyperactivity Disorder >> Tips to Help Kids and Adults with ADHD Stay Organized. NIMH » Home. [2018-07-22]. （原始内容存档于2016-12-29）.  参数|title=值左起第51位存在換行符 (帮助)
  81. ^ Robin, Arthur L. Family Therapy for Adolescents with ADHD. Child and adolescent psychiatric clinics of North America (Elsevier BV). 2014, 23 (4): 747–756. ISSN 1056-4993. PMID 25220084. doi:10.1016/j.chc.2014.06.001. 
  82. ^ ADHD-treatment. The Centers for Disease Control and Prevention. 2017-04-11 [2017-04-23]. （原始内容存档于2017-04-23）. 
  83. ^ 高淑芬. 家有過動兒：幫助ADHD孩子快樂成長. 台北: 心靈工坊. 2013-08-28. ISBN 9789866112805."家庭是ADHD孩子最重要的行為治療場域，更是支撐他們好好長大的關鍵。父母的支持能幫助孩子有勇氣面對困難，度過辛苦的學習過程。 身為父母，全心全意愛孩子是最基本的態度，一定要打從心裡認定：「我無條件愛我的孩子，如果連我都不願意幫助他，還有誰能幫他？我絕對不會放棄他，也不會放棄希望。我願意陪孩子一起努力！」 唯有讓孩子們在充滿安全感和接納的環境中長大，他們才能夠好好接受治療。"
  84. ^ 高淑芬. 家有過動兒：幫助ADHD孩子快樂成長. 台北: 心靈工坊. 2013-08-28. ISBN 9789866112805."無論如何，父母必須用「愛心、同理心」對待孩子並理解孩子在面對日常生活小事時所遇到的困難。多與孩子溝通，不要自以為知道孩子們在想什麼。願意把時間投資在促進親子關係上。不應該罵人，更不應該見到孩子劈頭就罵。這些種種將阻斷與孩子溝通的路。放下責備與自以為是後，父母和孩子往往將明白彼此之間有很多的誤會與淚水，需要釐清，更需要彼此的擁抱。"
  85. ^ Vincent Chin-Hung Chen, Duujian Tsai. ADHD Family Support Group： A Hospital-based Model in Taiwan.. International Journal of Child. Development and Mental Health. 2013-9, 2 (1): 21-29. （原始内容存档于2018-08-30）. 
  86. ^ 86.0 86.1 Lee, Pei-chin; Niew, Wern-ing; Yang, Hao-jan; Chen, Vincent Chin-hung; Lin, Keh-chung. A meta-analysis of behavioral parent training for children with attention deficit hyperactivity disorder. Research in Developmental Disabilities (Elsevier BV). 2012, 33 (6): 2040–2049. ISSN 0891-4222. doi:10.1016/j.ridd.2012.05.011. 
  87. ^ Ensuring dignities for families of children with ADHD by Vincent Chin-Hung Chen Professor of Chang Gung University. The World Dignity Project Bulletin - August 2019 issue. [2019-08-11]. 
  88. ^ 88.0 88.1 88.2 88.3 Behavior Therapy - ADHD - NCBDDD. CDC. 2017-04-19 [2017-11-01]. （原始内容存档于2017-12-09）. 
  89. ^ Chen, Vincent Chin-Hung; Yeh, Chin-Jung; Lee, Tzu-Chi; Chou, Jen-Yu; Shao, Wen-Chuan; Shih, Ding-Ho; Chen, Chun-Ing; Lee, Pei-Chin. Symptoms of attention deficit hyperactivity disorder and quality of life of mothers of school-aged children: The roles of child, mother, and family variables. The Kaohsiung journal of medical sciences (Elsevier BV). 2014, 30 (12): 631–638. ISSN 1607-551X. PMID 25476102. doi:10.1016/j.kjms.2014.09.001. 
  90. ^ Vincent Chin-Hung Chen, Pei-chin Lee, Duujian Tsai. A common link between clinical practice and research： the ADHD model for Central Taiwan. International Journal of Child. Development and Mental Health. 2014 Aug, 2 (2): 36-43. 
  91. ^ Lee, Pei-chin; Lin, Keh-chung; Robson, Deborah; Yang, Hao-jan; Chen, Vincent Chin-hung; Niew, Wern-ing. Parent–child interaction of mothers with depression and their children with ADHD. Research in Developmental Disabilities (Elsevier BV). 2013, 34 (1): 656–668. ISSN 0891-4222. doi:10.1016/j.ridd.2012.09.009. 
  92. ^ 中央社. 父母陪伴少品質差　孩子心理健康亮紅燈│TVBS新聞網. TVBS. 2017-05-12 [2017-07-17]. （原始内容存档于2018-03-07） （中文）. 
  93. ^ 93.0 93.1 獎斐忠政. 如何治療 #慣性說謊?. Facebook. 2018-2-12 [2018-7-31]. （原始内容存档于2018-7-31）. 
  94. ^ Janssen, Lotte; Kan, Cornelis C.; Carpentier, Pieter J.; Sizoo, Bram; Hepark, Sevket; Schellekens, Melanie P.J.; Donders, A. Rogier T.; Buitelaar, Jan K.; Speckens, Anne E.M. Mindfulness-based cognitive therapy v. treatment as usual in adults with ADHD: a multicentre, single-blind, randomised controlled trial. Psychological medicine (Cambridge University Press (CUP)). 2018-02-28: 1–11. ISSN 0033-2917. PMID 29486807. doi:10.1017/s0033291718000429. 
  95. ^ Hoxhaj, E.; Sadohara, C.; Borel, P.; D’Amelio, R.; Sobanski, E.; Müller, H.; Feige, B.; Matthies, S.; Philipsen, Alexandra. Mindfulness vs psychoeducation in adult ADHD: a randomized controlled trial. European archives of psychiatry and clinical neuroscience (Springer Nature). 2018-01-22. ISSN 0940-1334. PMID 29356899. doi:10.1007/s00406-018-0868-4. 
  96. ^ 96.0 96.1 96.2 96.3 96.4 96.5 96.6 FDA permits marketing of first medical device for treatment of ADHD. U.S. Food and Drug Administration. 2019-04-19 [2019-08-13]. 
  97. ^ McGough, James J.; Sturm, Alexandra; Cowen, Jennifer; Tung, Kelly; Salgari, Giulia C.; Leuchter, Andrew F.; Cook, Ian A.; Sugar, Catherine A.; Loo, Sandra K. Double-Blind, Sham-Controlled, Pilot Study of Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 2019, 58 (4): 403–411.e3. ISSN 0890-8567. PMC 6481187151974820200401 可免费查阅 请检查|pmc=值 (帮助). PMID 30768393. doi:10.1016/j.jaac.2018.11.013. 
  98. ^ pubmeddev; JJ, McGough; Al., Et. An eight-week, open-trial, pilot feasibility study of trigeminal nerve stimulation in youth with attention-deficit/hyperactivity disorder. - PubMed. NCBI. 2014-12-24 [2019-08-13]. 
  99. ^ Grigolon, Ruth B.; Blumberger, Daniel M.; Daskalakis, Zafiris J.; Trevizol, Alisson P. Editorial: Transcutaneous Trigeminal Nerve Stimulation for Children With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 2019, 58 (4): 392–394. ISSN 0890-8567. PMID 30768389. doi:10.1016/j.jaac.2019.01.006. 
  100. ^ 100.0 100.1 Visser, Susanna N.; Danielson, Melissa L.; Bitsko, Rebecca H.; Holbrook, Joseph R.; Kogan, Michael D.; Ghandour, Reem M.; Perou, Ruth; Blumberg, Stephen J. Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003–2011. Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 2014, 53 (1): 34–46.e2. ISSN 0890-8567. PMC 4473855 可免费查阅. PMID 24342384. doi:10.1016/j.jaac.2013.09.001. 
  101. ^ 101.0 101.1 NIMH » Attention-Deficit/Hyperactivity Disorder (ADHD). NIMH » Home. 2017-11-01 [2018-07-20]. （原始内容存档于2018-07-09）.  |accessdate=和|access-date=只需其一 (帮助)
  102. ^ Thomas, R.; Sanders, S.; Doust, J.; Beller, E.; Glasziou, P. Prevalence of Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis. PEDIATRICS (secondary source or tertiary source) (American Academy of Pediatrics (AAP)). 2015, 135 (4): e994–e1001 [2017-04-21]. doi:10.1542/peds.2014-3482. 7.2% (95% confidence interval: 6.7 to 7.8) 
  103. ^ Susan Gau. 兒童青少年精神醫學通訊-主題：拒學行為 (PDF). Child & Adolescent Psychiatry Newsletter. 2016-06, 15 (2). 
  104. ^ 陳錦宏; 高淑芬. ADHD注意力不足過動症家長手冊 A parenting guide for ADHD. Taipei City: 台灣兒童青少年精神醫學會. 2016-08. ISBN 978-986-93509-1-4. OCLC 982650259 （中文（臺灣））. 
  105. ^ 家有頑童？ 屏東醫院籲把握ADHD黃金治療期. 自由時報電子報 (中華民國台灣 屏東縣屏東市). 2016: 生活. （原始内容存档于2017-01-08） （中文（臺灣））. 
  106. ^ 106.0 106.1 陳鈞凱. 【有影】從白目衝動變拿文學、美術獎 台灣醫師靠這招解除過動兒「封印」. 匯流新聞網. 2018-08-17 [2018-12-15]. （原始内容存档于2018-12-16） （中文）. 根據統計，台灣ADHD盛行率約為7.5至9%，但健保資料研究顯示，只有近2%的孩子尋求診斷，更只有1%接受完整治療。超過7成的ADHD青少年有其他合併症狀，陳錦宏說，包括5成有學習障礙、4成感到焦慮、3成發生物質濫用行為、2成有憂鬱情形，且在學業、工作、身體意外傷害、家庭關係、車禍、藥酒癮的負面影響機率全都是一般人的2到3倍，而專業治療可以降低這些意外及藥酒癮50%的風險。治療非常的重要，陳錦宏強調，因ADHD是一種腦生理功能發展延遲的問題，大腦一半區域發展速度明顯較慢，美國國家衛生研究院花了10年追蹤更發現，ADHD兒童大腦皮質發展比正常兒童慢3年，部分更會持續到青春期或成年之後。 
  107. ^ Medscape Log In. Medscape Education. 2010-01-01 [2018-06-14]. （原始内容存档于2018-06-14）. Short-acting stimulants have been available for decades, but their use as first-line treatment is not advised. These agents require 3-4 daily doses to sustain effectiveness throughout the day. This is a tall order for patients with preexisting struggles with time management and organization. Furthermore, because behavioral response is linked to drug metabolism and these agents have a therapeutic effect that wanes within hours of administration, it is difficult for a clinician to assess efficacy in patients with rapidly shifting blood levels. For these reasons, the use of short-acting stimulants delays significant and consistent improvements in symptoms.[12] 
  108. ^ Medscape Log In. Medscape Education. 2010-01-01 [2018-06-14]. （原始内容存档于2018-06-14）. Using pharmacy data of 60,010 patients taking ADHD medications (41.6% adults), researchers found that adherence and persistence were best with long-acting stimulants, with long-acting amphetamines having the advantage over long-acting methylphenidate.[21]A long-acting drug and a higher therapeutic dose may make a marked difference. If the patient is resistant to one agent, then trying a different medication might be more effective and elicit better adherence. In most cases, long-acting ADHD medications are best because they can provide a more rapid response, which further increases the likelihood of medication adherence. 
  109. ^ FDA Asks Attention-Deficit Hyperactivity Disorder (ADHD) Drug Manufacturers to Develop Patient Medication Guides. U S Food and Drug Administration Home Page. 2016-11-07 [2017-12-09]. 
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  112. ^ Biederman, Joseph. New-Generation Long-Acting Stimulants for the Treatment of Attention-Deficit/Hyperactivity Disorder. Medscape. 2003 [2016-06-19]. （原始内容存档于2003-12-07）. As most treatment guidelines and prescribing information for stimulant medications relate to experience in school-aged children, prescribed doses for older patients are lacking. Emerging evidence for both methylphenidate and Adderall indicate that when weight-corrected daily doses, equipotent with those used in the treatment of younger patients, are used to treat adults with ADHD, these patients show a very robust clinical response consistent with that observed in pediatric studies. These data suggest that older patients may require a more aggressive approach in terms of dosing, based on the same target dosage ranges that have already been established – for methylphenidate, 1–1.5–2 mg/kg/day, and for D,L-amphetamine, 0.5–0.75–1 mg/kg/day....
    In particular, adolescents and adults are vulnerable to underdosing, and are thus at potential risk of failing to receive adequate dosage levels. As with all therapeutic agents, the efficacy and safety of stimulant medications should always guide prescribing behavior: careful dosage titration of the selected stimulant product should help to ensure that each patient with ADHD receives an adequate dose, so that the clinical benefits of therapy can be fully attained.     
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  117. ^ Medical Encyclopedia → Attention deficit hyperactivity disorder. medlineplus.gov. 2017-01-05 [2017-01]. （原始内容存档于2017-01-26）. Psychostimulants (also known as stimulants) are the most commonly used medicines. Although these drugs are called stimulants, they actually have a calming effect in people with ADHD. 
  118. ^ Signs and symptoms of Attention Deficit Hyperactivity Disorder, National Institute of Mental Health.. nimh.nih.gov. National Institute of mental health. 2013-03 [2017-01]. （原始内容存档于2016-12-29）. It is normal to have some inattention, unfocused motor activity and impulsivity, but for people with ADHD, these behaviors/are more severe, occur more often, interfere with or reduce the quality of how they functions socially, at school, or in a job. 
  119. ^ 衛生福利部精神疾病衛教叢書 注意力不足過動症，第19至20頁「反之，有些家長或孩童會以為使用藥物就像吃了「聰明藥」一切都解決了，而對於藥物過度依賴。卻忽略藥物只是提供孩子學習與接受指導的最佳時機，藉由此時建立起學習策略、人際互動、行為管理的技巧，才是孩子一生受用的能力，也有機會不靠藥物自我管理。」
  120. ^ 120.0 120.1 Attention Deficit-Hyperactivity Disorder Information Page. National Institute of Neurological Disorders and Stroke. 2018-06-15 [2018-07-13]. （原始内容存档于2018-04-23）. The usual course of treatment may include medications such as methylphenidate (Ritalin) or dextroamphetamine (Dexedrine), which are stimulants that decrease impulsivity and hyperactivity and increase attention. The U.S. Food and Drug Administration has approved the generic versions of Strattera (atomoxetine) to treat ADHD in pediatric and adult individuals. Most experts agree that treatment for ADHD should address multiple aspects of the individual's functioning and should not be limited to the use of medications alone. Treatment should include structured classroom management, parent education (to address discipline and limit-setting), and tutoring and/or behavioral therapy for the child. 
  121. ^ Gray, Christina; Climie, Emma A. Children with Attention Deficit/Hyperactivity Disorder and Reading Disability: A Review of the Efficacy of Medication Treatments. Frontiers in Psychology (Frontiers Media SA). 2016-07-05, 07. ISSN 1664-1078. doi:10.3389/fpsyg.2016.00988. 
  122. ^ Leahy, Laura G. Diagnosis and Treatment of ADHD in Children vs Adults: What Nurses Should Know. Archives of Psychiatric Nursing (Elsevier BV). 2018. ISSN 0883-9417. doi:10.1016/j.apnu.2018.06.013. 
  123. ^ Goodman, David W.; Starr, H. Lynn; Ma, Yi-Wen; Rostain, Anthony L.; Ascher, Steve; Armstrong, Robert B. Randomized, 6-Week, Placebo-Controlled Study of Treatment for Adult Attention-Deficit/Hyperactivity Disorder. The Journal of Clinical Psychiatry (Physicians Postgraduate Press, Inc). 2016-08-02, 78 (01): 105–114. ISSN 0160-6689. doi:10.4088/jcp.15m10348. 
  124. ^ Barkley, RA; DuPaul, GJ; McMurray, MB, Attention deficit disorder with and without hyperactivity: clinical response to three dose levels of methylphenidate., Pediatrics, 1991, 87 (4): 519–31, ISSN 0031-4005, PMID 2011430 
  125. ^ 125.0 125.1 Vincent Chin-Hung Chen, Yao-Hsu Yang, Yin-To Liao, Ting-Yu Kuo, Hsin-Yi Liang, Kuo-You Huang, Yin-Cheng Huang, Yena Lee, Roger S. McIntyre & Tzu-Chin Lin. The association between methylphenidate treatment and the risk for fracture among young ADHD patients: A nationwide population-based study in Taiwan. PloS one. 2017, 12 (3): e0173762. PMID 28296941. doi:10.1371/journal.pone.0173762. 
  126. ^ 126.0 126.1 126.2 126.3 Abuse, National Institute on Drug. Stimulant ADHD Medications: Methylphenidate and Amphetamines. （原始内容存档于2017-07-10）. 
  127. ^ Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D'Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik. Stimulant ADHD medication and risk for substance abuse. Journal of Child Psychology and Psychiatry. 2014, 55 (8): 878–885. ISSN 0021-9630. doi:10.1111/jcpp.12164. Results_ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57–0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. 
  128. ^ Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D'Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik. Stimulant ADHD medication and risk for substance abuse. Journal of Child Psychology and Psychiatry. 2014, 55 (8): 878–885. ISSN 0021-9630. doi:10.1111/jcpp.12164. Conclusions：We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. 
  129. ^ Soren Dalsgaard, James F. Leckman, Preben Bo Mortensen, Helena Skyt Nielsen & Marianne Simonsen. Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: a prospective cohort study. The lancet. Psychiatry. 2015-08, 2 (8): 702–709. PMID 26249301. doi:10.1016/S2215-0366(15)00271-0. INTERPRETATION: Children with ADHD had an increased risk of injuries compared with other children. Treatment with ADHD drugs reduced the risk of injuries by up to 43% and emergency ward visits by up to 45% in children with ADHD. Taken together with previous findings of accidents being the most common cause of death in individuals with ADHD, these results are of major public health importance. 
  130. ^ Rafael Mikolajczyk, Johannes Horn, Niklas Schmedt, Ingo Langner, Christina Lindemann & Edeltraut Garbe. Injury prevention by medication among children with attention-deficit/hyperactivity disorder: a case-only study. JAMA pediatrics. 2015-04, 169 (4): 391–395. PMID 25686215. doi:10.1001/jamapediatrics.2014.3275. CONCLUSIONS AND RELEVANCE: No significant risk reduction for hospitalizations with injury diagnoses was observed during periods of ADHD medication, but there was a preventive effect on the risk of brain injuries (34% risk reduction). The effects were controlled for time-invariant characteristics of the patients by the study design. 
  131. ^ Helen Briggs; the journal JAMA Psychiatry. Vitamins ‘effective in treating ADHD symptoms’. BBC News. 2014-01-30 [2017-04-13]. （原始内容存档于2017-04-14）. Scientists from the Karolinska Institute studied 17,000 individuals with ADHD over a period of four years using data from health registers. They found individuals with ADHD had a higher risk of being involved in serious transport accidents, such as car or motorcycle crashes, compared with those without ADHD. Transport accidents were lower among men with ADHD who were on medication than among men with ADHD who did not take medication. Calculations showed 41% of transport accidents involving men with ADHD could have been avoided if they had received medication and carried on taking it during the course of the study. 
  132. ^ 132.0 132.1 Cardiac evaluation of patients receiving pharmacotherapy for attention deficit hyperactivity disorder. UpToDate. 2017-08-01 [2017-12-22]. （原始内容存档于2017-12-23）. What is clear, however, is limiting or delaying children's access to effective treatment for ADHD could have serious implications (such as increased risk of adolescent substance use disorder, academic failure, and accidents) in patients who are not effectively treated. 
  133. ^ Man, Kenneth K. C.; Ip, Patrick; Chan, Esther W.; Law, Siew-ling; Leung, Miriam T. Y.; Ma, Evelyn X. Y.; Quek, Wan-ting; Wong, Ian C. K. Effectiveness of Pharmacological Treatment for Attention-Deficit/Hyperactivity Disorder on Physical Injuries: A Systematic Review and Meta-Analysis of Observational Studies. CNS Drugs (Springer Nature). 2017, 31 (12): 1043–1055. ISSN 1172-7047. doi:10.1007/s40263-017-0485-1. 
  134. ^ 全民健康保險藥物給付項目及支付標準§83-全國法規資料庫入口網站. 全國法規資料庫入口網站: 1680-1681. [2018-07-16] （中文）. 
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  137. ^ Castells, X; Blanco-Silvente, L; Cunill, R. Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults.. The Cochrane database of systematic reviews. 2018-08-09, 8: CD007813. ISSN 1469-493X. PMID 30091808. doi:10.1002/14651858.CD007813.pub3. 
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  139. ^ 139.0 139.1 Parker J, Wales G, Chalhoub N, Harpin V. The long-term outcomes of interventions for the management of attention-deficit hyperactivity disorder in children and adolescents: a systematic review of randomized controlled trials. Psychology Research and Behavior Management. September 2013, 6: 87–99. PMC 3785407 可免费查阅. PMID 24082796. doi:10.2147/PRBM.S49114. Results suggest there is moderate-to-high-level evidence that combined pharmacological and behavioral interventions, and pharmacological interventions alone can be effective in managing the core ADHD symptoms and academic performance at 14 months. However, the effect size may decrease beyond this period. ... Only one paper examining outcomes beyond 36 months met the review criteria. ... There is high level evidence suggesting that pharmacological treatment can have a major beneficial effect on the core symptoms of ADHD (hyperactivity, inattention, and impulsivity) in approximately 80% of cases compared with placebo controls, in the short term.22 
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  144. ^ Spencer TJ, Brown A, Seidman LJ, Valera EM, Makris N, Lomedico A, Faraone SV, Biederman J. Effect of psychostimulants on brain structure and function in ADHD: a qualitative literature review of magnetic resonance imaging-based neuroimaging studies. The Journal of Clinical Psychiatry. September 2013, 74 (9): 902–17. PMC 3801446 可免费查阅. PMID 24107764. doi:10.4088/JCP.12r08287. 
  145. ^ Frodl T, Skokauskas N. Meta-analysis of structural MRI studies in children and adults with attention deficit hyperactivity disorder indicates treatment effects. Acta Psychiatrica Scandinavica. February 2012, 125 (2): 114–26. PMID 22118249. doi:10.1111/j.1600-0447.2011.01786.x. Basal ganglia regions like the right globus pallidus, the right putamen, and the nucleus caudatus are structurally affected in children with ADHD. These changes and alterations in limbic regions like ACC and amygdala are more pronounced in non-treated populations and seem to diminish over time from child to adulthood. Treatment seems to have positive effects on brain structure. 
  146. ^ Cortese, Samuele; Adamo, Nicoletta; Del Giovane, Cinzia; Mohr-Jensen, Christina; Hayes, Adrian J; Carucci, Sara; Atkinson, Lauren Z; Tessari, Luca; Banaschewski, Tobias; Coghill, David; Hollis, Chris; Simonoff, Emily; Zuddas, Alessandro; Barbui, Corrado; Purgato, Marianna; Steinhausen, Hans-Christoph; Shokraneh, Farhad; Xia, Jun; Cipriani, Andrea. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet Psychiatry. September 2018, 5 (9): 727–738. doi:10.1016/S2215-0366(18)30269-4. 
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  148. ^ Ibrahim K, Donyai P. Drug Holidays From ADHD Medication: International Experience Over the Past Four Decades. Journal of Attention Disorders. July 2015, 19 (7): 551–68. PMID 25253684. doi:10.1177/1087054714548035. （原始内容存档 (PDF)于30 June 2016）.  已忽略未知参数|df= (帮助)
  149. ^ 149.0 149.1 149.2 Malenka RC, Nestler EJ, Hyman SE. Sydor A, Brown RY , 编. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience 2nd. New York: McGraw-Hill Medical. 2009: 323, 368. ISBN 978-0-07-148127-4. supervised use of stimulants at therapeutic doses may decrease risk of experimentation with drugs to self-medicate symptoms. Second, untreated ADHD may lead to school failure, peer rejection, and subsequent association with deviant peer groups that encourage drug misuse. ... amphetamines and methylphenidate are used in low doses to treat attention deficit hyperactivity disorder and in higher doses to treat narcolepsy (Chapter 12). Despite their clinical uses, these drugs are strongly reinforcing, and their long-term use at high doses is linked with potential addiction 
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  218. ^ Storebø, Ole Jakob; Ramstad, Erica; Krogh, Helle B.; Nilausen, Trine Danvad; Skoog, Maria; Holmskov, Mathilde; Rosendal, Susanne; Groth, Camilla; Magnusson, Frederik L; Moreira-Maia, Carlos R; Gillies, Donna; Buch Rasmussen, Kirsten; Gauci, Dorothy; Zwi, Morris; Kirubakaran, Richard; Forsbøl, Bente; Simonsen, Erik; Gluud, Christian, Storebø, Ole Jakob , 编, Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD), The Cochrane database of systematic reviews (systematic review) (Chichester, UK: John Wiley & Sons, Ltd), 2015-11-25, (11), PMID 26599576, doi:10.1002/14651858.cd009885.pub2, Within the short follow-up periods typical of the included trials, there is some evidence that methylphenidate is associated with increased risk of non-serious adverse events, such as sleep problems and decreased appetite, but no evidence that it increases risk of serious adverse events.Better designed trials are needed to assess the benefits of methylphenidate. Given the frequency of non-serious adverse events associated with methylphenidate, the particular difficulties for blinding of participants and outcome assessors point to the advantage of large, 'nocebo tablet' controlled trials. 
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  227. ^ NIMH » Attention Deficit Hyperactivity Disorder. NIMH » Home. [2018-07-21]. （原始内容存档于2016-12-25）. Although not approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of ADHD, some antidepressants are sometimes used alone or in combination with a stimulant to treat ADHD. Antidepressants may help all of the symptoms of ADHD and can be prescribed if a patient has bothersome side effects from stimulants. Antidepressants can be helpful in combination with stimulants if a patient also has another condition, such as an anxiety disorder, depression, or another mood disorder.  |accessdate=和|access-date=只需其一 (帮助)
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  232. ^ CONCERTA- methylphenidate hydrochloride tablet, extended release. DailyMed. 2018-10-09 [2018-10-18]. （原始内容存档于2017-03-26）. 14.3 Adults
    Two double-blind, placebo-controlled studies were conducted in 627 adults aged 18 to 65 years. The controlled studies compared CONCERTA® administered once daily and placebo in a multicenter, parallel-group, 7-week dose-titration study (Study 5) (36 to 108 mg/day) and in a multicenter, parallel-group, 5-week, fixed-dose study (Study 6) (18, 36, and 72 mg/day).
    Study 5 demonstrated the effectiveness of CONCERTA® in the treatment of ADHD in adults aged 18 to 65 years at doses from 36 mg/day to 108 mg/day based on the change from baseline to final study visit on the Adult ADHD Investigator Rating Scale (AISRS). Of 226 patients who entered the 7-week trial, 110 were randomized to CONCERTA® and 116 were randomized to placebo. Treatment was initiated at 36 mg/day and patients continued with incremental increases of 18 mg/day (36 to 108 mg/day) based on meeting specific improvement criteria with acceptable tolerability. At the final study visit, mean change scores (LS Mean, SEM) for the investigator rating on the AISRS demonstrated that CONCERTA®was statistically significantly superior to placebo.
    Study 6 was a multicenter, double-blind, randomized, placebo-controlled, parallel-group, dose-response study (5-week duration) with 3 fixed-dose groups (18, 36, and 72 mg). Patients were randomized to receive CONCERTA® administered at doses of 18 mg (n=101), 36 mg (n=102), 72 mg/day (n=102), or placebo (n=96). All three doses of CONCERTA® were statistically significantly more effective than placebo in improving CAARS (Conners' Adult ADHD Rating Scale) total scores at double-blind end point in adult subjects with ADHD.     
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  249. ^ Frequently Asked Questions. Official website for Strattera. Strattera-Eli Lilly. 2016-09 [2017-02]. （原始内容存档于2017-01-09）. Strattera works gradually, so improvements are seen over time. When your child starts treatment with Strattera, it's important to set some small goals. Remember to be patient—some people notice small changes within 2 weeks, and by 4 to 6 weeks at target dose you should see significant improvement in your child's symptoms. 
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  253. ^ Chi-Yung Shang, Yi-Lei Pan, Hsiang-Yuan Lin, Lin-Wan Huang & Susan Shur-Fen Gau. An Open-Label, Randomized Trial of Methylphenidate and Atomoxetine Treatment in Children with Attention-Deficit/Hyperactivity Disorder. Journal of child and adolescent psychopharmacology. 2015-09, 25 (7): 566–573. PMID 26222447. doi:10.1089/cap.2015.0035. At week 24, mean changes in ADHD-RS-IV Inattention scores were 13.58 points (Cohen's d, -3.08) for OROS-methylphenidate and 12.65 points (Cohen's d, -3.05) for atomoxetine; and mean changes in ADHD-RS-IV Hyperactivity-Impulsivity scores were 10.16 points (Cohen's d, -1.75) for OROS-methylphenidate and 10.68 points (Cohen's d, -1.87) for atomoxetine. 
  254. ^ 衛生福利部精神疾病衛教叢書 注意力不足過動症，第22頁「atomoxetine，用在病情 較為複雜、或是無法忍受MPH副作用的患者，然而一般發現其對於專注度的改善沒有MPH明顯」
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  256. ^ L. Eugene Arnold, Michael G. Aman, Amelia M. Cook, Andrea N. Witwer, Kristy L. Hall, Susan Thompson & Yaser Ramadan. Atomoxetine for hyperactivity in autism spectrum disorders: placebo-controlled crossover pilot trial. Journal of the American Academy of Child and Adolescent Psychiatry. 2006-10, 45 (10): 1196–1205. PMID 17003665. doi:10.1097/01.chi.0000231976.28719.2a. 
  257. ^ Matthew Siegel, MD.,Craig Erickson, MD., MS, Jean A. Frazier, MD., Toni Ferguson, Autism Society of America., Eric Goepfert, MD., Gagan Joshi, MD., Quentin Humberd, MD., Bryan H. King, MD., Amy Lutz, EASI Foundation: Ending Aggression and Self-Injury in the Developmentally Disabled., Louis Kraus, MD., Alice Mao, MD., Adelaide Robb, MD., Jeremy Veenstra-VanderWeele, MD, PhD., Paul Wang, MD, Autism SpeaksCarmen J. Head, MPH, CHES, Director, Research, Development, & WorkforceEve, Bender, Scientific Editor. Autism_Spectrum_Disorder_Parents_Medication_Guide (PDF). 3615 Wisconsin Avenue, NW, Washington, DC 20016-3007: American Academy of Child and Adolescent Psychiatry. 2016: 13. （原始内容存档 (PDF)于2017-04-11） （英语）. Atomoxetine (Strattera) has also been researched in controlled studies for treatment of ADHD in children with autism, and showed some improvements,particularly for hyperactivity and impulsivity. 
  258. ^ Parent's Medication Guide: ADHD. American Psychiatric Association (Guidelines (Tertiary source)). American Psychiatric Association & American Academy of Child and Adolescent Psychiatry (AACAP). 2013-06 [2017-01]. （原始内容存档于2017-02-02）. Though not FDA-approved for combined treatment, atomoxetine (Strattera) is sometimes used in conjunction with stimulants as an off-label combination therapy.  |archiveurl=和|archive-url=只需其一 (帮助); |accessdate=和|access-date=只需其一 (帮助); |archivedate=和|archive-date=只需其一 (帮助)
  259. ^ Medical Encyclopedia → Attention deficit hyperactivity disorder. MedlinePlus.gov. 2017-01-05 [2017-01]. （原始内容存档于2017-01-26）. Medicine combined with behavioral treatment often works best. Different ADHD medicines can be used alone or combined with each other. The doctor will decide which medicine is right, based on the person's symptoms and needs. 
  260. ^ Treuer T, Gau SS, Méndez L, Montgomery W, Monk JA, Altin M; et al. A systematic review of combination therapy with stimulants and atomoxetine for attention-deficit/hyperactivity disorder, including patient characteristics, treatment strategies, effectiveness, and tolerability.. Journal of Child and Adolescent Psychopharmacology (systematic review (Secondary source)). 2013, 23 (3): 179–93. PMC 3696926 可免费查阅. PMID 23560600. doi:10.1089/cap.2012.0093. Existing evidence suggests, but does not confirm, that this drug combination may benefit some, but not all, patients who have tried several ADHD medications without success. 
  261. ^ Perugi G, Vannucchi G. The use of stimulants and atomoxetine in adults with comorbid ADHD and bipolar disorder.. Expert Opin Pharmacother. 2015, 16 (14): 2193–204. PMID 26364896. doi:10.1517/14656566.2015.1079620. Although systematic trials on the use of stimulants and ATX in ADHD-BD comorbidity in adulthood are necessary, both treatments should be considered possible options to be carefully evaluated once the patient has been stabilized. 
  262. ^ NIMH » Mental Health Medications. NIMH » Home. [2019-05-17]. （原始内容存档于2019-04-06）. Note: In 2002, the FDA approved the non-stimulant medication atomoxetine for use as a treatment for ADHD. 
  263. ^ NIMH » Attention Deficit Hyperactivity Disorder. NIMH » Home. [2018-07-21]. （原始内容存档于2016-12-25）. Non-stimulants. A few other ADHD medications are non-stimulants. These medications take longer to start working than stimulants, but can also improve focus, attention, and impulsivity in a person with ADHD. Doctors may prescribe a non-stimulant: when a person has bothersome side effects from stimulants; when a stimulant was not effective; or in combination with a stimulant to increase effectiveness.  |accessdate=和|access-date=只需其一 (帮助)
  264. ^ Label of Strattera consisting of atomoxetine. DailyMed.gov (Leaflet/label (Tertiary source)). Eli Lilly Company. 2015-06 [2017-02]. 7.7 Methylphenidate\ Coadministration of methylphenidate with STRATTERA did not increase cardiovascular effects beyond those seen with methylphenidate alone. 
  265. ^ 265.0 265.1 Parent's Medication Guide: ADHD. American Psychiatric Association. American Psychiatric Association & American Academy of Child and Adolescent Psychiatry (AACAP). 2013-06 [2017-01-01]. （原始内容存档于2017-02-02）. Extended release guanfacine (Intuniv) and extended release clonidine (Kapvay) are approved to be added to stimulant treatment when the stimulant doesn’t fully reduce the ADHD symptoms. 
  266. ^ Loo SK, Bilder RM, Cho AL, Sturm A, Cowen J, Walshaw P; et al. Effects of d-Methylphenidate, Guanfacine, and Their Combination on Electroencephalogram Resting State Spectral Power in Attention-Deficit/Hyperactivity Disorder.. J Am Acad Child Adolesc Psychiatry. 2016, 55 (8): 674–682.e1. PMID 27453081. doi:10.1016/j.jaac.2016.04.020. 
  267. ^ 267.0 267.1 McCracken JT, McGough JJ, Loo SK, Levitt J, Del'Homme M, Cowen J; et al. Combined Stimulant and Guanfacine Administration in Attention-Deficit/Hyperactivity Disorder: A Controlled, Comparative Study.. J Am Acad Child Adolesc Psychiatry. 2016, 55 (8): 657–666.e1. PMC 4976782 可免费查阅. PMID 27453079. doi:10.1016/j.jaac.2016.05.015. 
  268. ^ 268.0 268.1 Bilder RM, Loo SK, McGough JJ, Whelan F, Hellemann G, Sugar C; et al. Cognitive Effects of Stimulant, Guanfacine, and Combined Treatment in Child and Adolescent Attention-Deficit/Hyperactivity Disorder.. J Am Acad Child Adolesc Psychiatry. 2016, 55 (8): 667–73. PMC 4964604 可免费查阅. PMID 27453080. doi:10.1016/j.jaac.2016.05.016. 
  269. ^ Combining medications could offer better results for ADHD patients. Science News. Elsevier. 2016-08-01 [2017-01]. （原始内容存档于2017-01-02）. Summary:Three studies report that combining two standard medications could lead to greater clinical improvements for children with attention-deficit/hyperactivity disorder (ADHD) than either ADHD therapy alone. At present, studies show that the use of several ADHD medications result in significant reductions in ADHD symptoms. However, so far there is no conclusive evidence that these standard drug treatments also improve long-term academic, social, and clinical outcomes.  |archiveurl=和|archive-url=只需其一 (帮助); |accessdate=和|access-date=只需其一 (帮助); |archivedate=和|archive-date=只需其一 (帮助)
  270. ^ Death with the concomitant use of clonidine or guanfacine and amphetamine／dextroamphetamine or dexmethylphenidate or dextroamphetamine or lisdexamfetamine or methylphenidate. (PDF). American Psychiatric Association. Department of Health and Human Services & Public Health Service & Food and Drug Administration & Center for Drug Evaluation and Research & Office of Surveillance and Epidemiology. 2010-07-06 [2017-01]. （原始内容存档 (PDF)于2017-02-15）. 
  271. ^ LABEL: STRATTERA- atomoxetine hydrochloride capsule STRATTERA- atomoxetine hydrochloride. DailyMed. 2017-03-16 [2017-24-23]. （原始内容存档于2017-09-02）. Swallow STRATTERA capsules whole with water or other liquids. 
  272. ^ John-Michael Sauer, Barbara J. Ring & Jennifer W. Witcher. Clinical pharmacokinetics of atomoxetine. Clinical pharmacokinetics. 2005, 44 (6): 571–590. PMID 15910008. doi:10.2165/00003088-200544060-00002. After single oral dose, atomoxetine reaches maximum plasma concentration within about 1-2 hours of administration. In extensive metabolisers, atomoxetine has a plasma half-life of 5.2 hours, while in poor metabolisers, atomoxetine has a plasma half-life of 21.6 hours. 
  273. ^ STRATTERA® (atomoxetine hydrochloride). TGA eBusiness Services. Eli Lilly Australia Pty. Limited. 2013-08-21 [2013-11-10]. （原始内容存档于2017-04-06）. 
  274. ^ ATOMOXETINE HYDROCHLORIDE capsule [Mylan Pharmaceuticals Inc.]. DailyMed. Mylan Pharmaceuticals Inc. 2011-10 [2013-11-10]. （原始内容存档于2013-11-10）. 
  275. ^ LABEL: CLONIDINE HYDROCHLORIDE EXTENDED-RELEASE- clonidine hydrochloride tablet, extended release. DailyMed. 2016-09-30 [2017-04-23]. （原始内容存档于2017-04-23）. 
  276. ^ 276.0 276.1 廖曉菁; 楊智超. 成人之注意力不足及過動症. National Taiwan University Hospital. [2017-04-14]. （原始内容存档于2018-01-29）. 
  277. ^ 277.0 277.1 CLONIDINE HYDROCHLORIDE - clonidine hydrochloride tablet. DailyMed. 2017-04-13. （原始内容存档于2017-04-14）. Clonidine hydrochloride USP tablets act relatively rapidly. The patient's blood pressure declines within 30 to 60 minutes after an oral dose, the maximum decrease occurring within 2 to 4 hours. 
  278. ^ New Zealand Datasheet\Name of Medicine\CATAPRES®\Clonidine hydrochloride (PDF). 2012-02-24 [2017-04-13]. （原始内容存档 (PDF)于2017-04-08） （en-nz）. 
  279. ^ Catapres-drug/clinical-pharmacology. RxList. [2017-04-13]. （原始内容存档于2017-04-14）. 
  280. ^ CATAPRES® 100 TABLETS (PDF). ABN 52 000 452 308 78 Waterloo Road NORTH RYDE NSW 2113: Boehringer Ingelheim Pty Limited. 2016-11-07 [2014-04-14]. （原始内容存档 (PDF)于2015-02-28） （澳大利亚英语）. Pharmacokinetic Studies Absorption and distribution The pharmacokinetics of clonidine is dose-proportional in the range of 75-300 micrograms. Clonidine, the active ingredient of CATAPRES, is well absorbed from the gastrointestinal tract and undergoes a minor first pass effect. Peak plasma concentrations are reached within 1-3 hours after oral administration. The duration of action varies from 6-12 hours, the duration of action being longer in the milder hypertensives. The plasma protein binding is 30-40%. Metabolism and excretion The terminal elimination half-life of clonidine has been found to range from 9-26 hours in patients with normal renal function. With impaired enal function it has been reported to increase to 18-48 hours  参数|quote=值左起第412位存在換行符 (帮助)
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  284. ^ Guanfacine: MedlinePlus Drug Information. MedlinePlus. [2018-07-13]. （原始内容存档于2018-05-27）. 
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  287. ^ Pharmacotherapy-for-adult-attention-deficit-hyperactivity-disorder. UpToDate. [2018-03-17]. （原始内容存档于2018-03-17）. For adults with ADHD and co-occurring generalized anxiety disorder, we suggest treatment with the combination of a stimulant and an SSRI over other medications. For adults with ADHD and co-occurring depression, we suggest first-line treatment with bupropionrather than other medications (Grade 2C). Treatment with an SSRI plus a stimulant is also a reasonable option. 
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  292. ^ STRATTERA- atomoxetine hydrochloride capsule STRATTERA- atomoxetine hydrochloride. DailyMed. [2018-12-16]. （原始内容存档于2017-09-02）. 14.2 ADHD studies in Adults
    The effectiveness of STRATTERA in the treatment of ADHD was established in 2 randomized, double-blind, placebo-controlled clinical studies of adult patients, age 18 and older, who met DSM-IV criteria for ADHD.
    Signs and symptoms of ADHD were evaluated using the investigator-administered Conners Adult ADHD Rating Scale Screening Version (CAARS), a 30-item scale. The primary effectiveness measure was the 18-item Total ADHD Symptom score (the sum of the inattentive and hyperactivity/impulsivity subscales from the CAARS) evaluated by a comparison of mean change from baseline to endpoint using an intent-to-treat analysis.
    In 2 identical, 10-week, randomized, double-blind, placebo-controlled acute treatment studies (Study 5, N=280; Study 6, N=256), patients received either STRATTERA or placebo. STRATTERA was administered as a divided dose in the early morning and late afternoon/early evening and titrated according to clinical response in a range of 60 to 120 mg/day. The mean final dose of STRATTERA for both studies was approximately 95 mg/day. In both studies, ADHD symptoms were statistically significantly improved on STRATTERA, as measured on the ADHD Symptom score from the CAARS scale. Examination of population subsets based on gender and age (<42 and ≥42) did not reveal any differential responsiveness on the basis of these subgroupings. There was not sufficient exposure of ethnic groups other than Caucasian to allow exploration of differences in these subgroups.     
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  299. ^ Lofthouse N, Arnold LE, Hurt E. Current status of neurofeedback for attention-deficit/hyperactivity disorder. Curr Psychiatry Rep. October 2012, 14 (5): 536–42. PMID 22890816. doi:10.1007/s11920-012-0301-z. 
  300. ^ Holtmann, M; Sonuga-Barke, E; Cortese, S; Brandeis, D. Neurofeedback for ADHD: A Review of Current Evidence. Child and Adolescent Psychiatric Clinics of North America. October 2014, 23 (4): 789–806. PMID 25220087. doi:10.1016/j.chc.2014.05.006. hdl:1854/LU-5841198. 
  301. ^ Author:Graham A Colditz, MD, DrPH; Section Editor:David Seres, MD; Deputy Editor:Lisa Kunins, MD. Healthy diet in adults. UpToDate. [2019-08-23]. 
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  308. ^ 308.0 308.1 308.2 308.3 Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013-03, 170 (3): 275–289. PMID 23360949. doi:10.1176/appi.ajp.2012.12070991. Free fatty acid supplementation and artificial food color exclusions appear to have beneficial effects on ADHD symptoms, although the effect of the former are small and those of the latter may be limited to ADHD patients with food sensitivities... 
  309. ^ 309.0 309.1 Nigg JT, Holton K. Restriction and elimination diets in ADHD treatment. Child Adolesc Psychiatr Clin N Am (Review). 2014-10, 23 (4): 937–53. PMC 4322780 可免费查阅. PMID 25220094. doi:10.1016/j.chc.2014.05.010. an elimination diet produces a small aggregate effect but may have greater benefit among some children. Very few studies enable proper evaluation of the likelihood of response in children with ADHD who are not already preselected based on prior diet response. 
  310. ^ Ertürk, E; Wouters, S; Imeraj, L; Lampo, A. Association of ADHD and Celiac Disease: What Is the Evidence? A Systematic Review of the Literature.. Journal of Attention Disorders (Review). 2016-01-29. PMID 26825336. doi:10.1177/1087054715611493. 
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  313. ^ Bloch, MH; Mulqueen, J. Nutritional supplements for the treatment of ADHD.. Child and adolescent psychiatric clinics of North America. 2014-10, 23 (4): 883–97. PMID 25220092. doi:10.1016/j.chc.2014.05.002. 
  314. ^ Krause J. SPECT and PET of the dopamine transporter in attention-deficit/hyperactivity disorder. Expert Rev. Neurother. 2008-04, 8 (4): 611–625. PMID 18416663. doi:10.1586/14737175.8.4.611. Zinc binds at ... extracellular sites of the DAT [103], serving as a DAT inhibitor. In this context, controlled double-blind studies in children are of interest, which showed positive effects of zinc [supplementation] on symptoms of ADHD [105,106]. It should be stated that at this time [supplementation] with zinc is not integrated in any ADHD treatment algorithm. 
  315. ^ Chang, Jane Pei-Chen; Su, Kuan-Pin; Mondelli, Valeria; Pariante, Carmine M. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology (Springer Nature). 2017-07-25, 43 (3): 534–545. ISSN 0893-133X. PMC 566946473458 可免费查阅 请检查|pmc=值 (帮助). PMID 28741625. doi:10.1038/npp.2017.160.  |year=与|date=不匹配 (帮助)
  316. ^ Richardson, Alexandra J.; Burton, Jennifer R.; Sewell, Richard P.; Spreckelsen, Thees F.; Montgomery, Paul. Scott, James G. , 编. Docosahexaenoic Acid for Reading, Cognition and Behavior in Children Aged 7–9 Years: A Randomized, Controlled Trial (The DOLAB Study). PLoS ONE (Public Library of Science (PLoS)). 2012-09-06, 7 (9): e43909. ISSN 1932-6203. doi:10.1371/journal.pone.0043909. 
  317. ^ Omega Fish oils don't improve school children's reading skills or memory, study finds. birmingham.ac.uk. 2018-03-02 [2018-03-14]. 
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  320. ^ Königs A, Kiliaan AJ. Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment. Neuropsychiatr. Dis. Treat. July 2016, 12: 1869–1882. PMC 4968854 可免费查阅. PMID 27555775. doi:10.2147/NDT.S68652. 
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  323. ^ Tomaska LD, Brooke-Taylor S. Food Additives – General. Motarjemi Y, Moy GG, Todd EC (编). Encyclopedia of Food Safety 3 1st. Amsterdam: Elsevier/Academic Press: 449–54. 2014. ISBN 978-0-12-378613-5. OCLC 865335120. 
  324. ^ FDA, Background Document for the Food Advisory Committee: Certified Color Additives in Food and Possible Association with Attention Deficit Hyperactivity Disorder in Children (PDF), U.S. Food and Drug Administration, March 2011, （原始内容存档 (PDF)于6 November 2015）  已忽略未知参数|df= (帮助)
  325. ^ 中醫有效治療小兒過動症及妥瑞氏症記者會. 中華民國中醫師公會全國聯合會. 臺灣. 2018-08-09 [2018-08-11]. （原始内容存档于2018-08-11） （中文）. 注意力不足過動症（Attention Deficit Hyperactivity Disorder，簡稱 ADHD）及妥瑞氏症（Tourette Syndrom，簡稱TS）是常見發病於兒童的慢性神經精神異常疾病(Neuropsychiatric disorder)，目前不論中西醫都在尋求根治的方法。長久以來，傳統中醫在改善這類慢性長期精神生理疾病症狀方面，具有顯著的療效及實證案例，透過中醫藥的幫助，減低病症對日常生活之影響，提升生活品質及學業表現，讓孩子有尊嚴、不受歧視、健康自在地活出自己 
  326. ^ 中醫有效治療小兒過動症及妥瑞氏症記者會 (PDF). 中華民國中醫師公會全國聯合會. 臺灣. 2018-08-09 [2018-08-11]. （原始内容 (PDF)存档于2018-08-11） （中文（臺灣））. 2010年發表於《Complementary Therapies in Medicine(醫學補充療法)》雜誌的隨機雙盲對照試驗顯示，電針加上行為療法對於注意力不足過動症小朋友有顯著的療效，且能減少復發率。研究中針對頭部（百會、四神聰、神庭、本神、太陽、印堂）、 背 部膀胱經（肝俞、脾俞、腎俞）、足部腎經（太溪）、足部肝經（太衝）進行針刺治療，達到改善注意力不足與過動的症狀，同時改善情緒障礙與提升腦部發育 
  327. ^ 327.0 327.1 327.2 327.3 327.4 Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O. Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review. J. Neural. Transm. (Vienna) (systematic review (secondary source)). 2016-07. PMID 27400928. doi:10.1007/s00702-016-1593-7. 
  328. ^ Kamp CF, Sperlich B, Holmberg HC. Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters. Acta Paediatr. 2014-07, 103 (7): 709–14. PMID 24612421. doi:10.1111/apa.12628. 
  329. ^ 329.0 329.1 Kamp, Carolin Friederike; Sperlich, Billy; Holmberg, Hans-Christer. Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters. Acta Paediatr. 2014-07-01, 103 (7): 709–714. doi:10.1111/apa.12628. （原始内容存档于2017-02-16） –通过Wiley Online Library. 
  330. ^ DJ, Rickson. Instructional and improvisational models of music therapy with adolescents who have attention deficit hyperactivity disorder (ADHD): a comparison o... - PubMed. NCBI. 2018-12-27 [2018-12-27]. 
  331. ^ Rick Nauert PhD. Music Lessons May Help Kids with Autism & ADHD. psychcentral.com. the Radiological Society of North America (RSNA). 2016-11-23 [2017-01]. （原始内容存档于2016-11-30）. A new imaging study suggests taking music lessons increases brain fiber connections in children. As such, the training may be useful in treating autism and attention-deficit hyperactivity disorder (ADHD), according to researchers from the Radiological Society of North America (RSNA). 
  332. ^ Carrer, Luiz Rogério Jorgensen. Music and Sound in Time Processing of Children with ADHD. Frontiers in psychiatry (Frontiers Media SA). 2015-09-28, 6. ISSN 1664-0640. PMC 4585247 可免费查阅. PMID 26441688. doi:10.3389/fpsyt.2015.00127. 
  333. ^ NA, Jackson. A survey of music therapy methods and their role in the treatment of early elementary school children with ADHD. - PubMed. NCBI. 2018-12-27 [2018-12-27]. 

註解

  1. ^ 雖然中樞神經刺激劑（methylphenidate & amphetamine）與非典型中樞神經刺激劑（atomoxetine）能改善ADHD的核心症狀，但往往無法全面治癒患者在管理：時間與規劃方面的困難；社交和情緒方面的自我控制[50][51][52]。 而認知行為治療的領域中，為此再建立出專門針對改善ADHD執行功能缺陷的「ADHD認知行為治療」[38]
  2. ^ 減少環境中的分心誘因。
  3. ^ 在《找回專注力 成人ADHD全方位自助手冊》中，「改善ADHD症狀的實用技巧與策略」涵蓋：創造有助於專注的環境與內在策略、強化記憶力的妙方、時間管理、改善衝動問題與人際關係、學習表達和傾聽、改善情緒、改善與親人與情人的關係等。[15]
  4. ^ 陳錦宏醫師的研究發現，因 ADHD 照顧者本身為 ADHD 症狀衍生功能損害的負面後果承擔者，如校園衝突、學習困難，生活困難，所以本身也是壓力的高風險群，ADHD 家庭研究顯示， ADHD 媽媽的生活品質較差，而沮喪的媽媽較難正向協助孩子。這就產生了 ADHD 照護中的核心困難[89] [90][91][86]
  5. ^ 全美國ADHD的用藥率從2007-2011年成長了4%，其中男性青少年用藥比率是相對其他族群來說，成長最快的。[100][101]
  6. ^ 藥物不會成癮且ADHD患者往往不易維持生活組織及時間等。[107]
  7. ^ 又名中樞神經活化劑、中樞神經興奮劑、興奮劑
  8. ^ 也就是中樞神經刺激劑類
  9. ^ 又稱為「派醋甲酯」
  10. ^ 兒童或青少年服用中樞神經刺激劑者則應額外監測身高。
  11. ^ 中樞神經過度刺激或心跳增加都可能推升基礎代謝率。
  12. ^ 尿液滯留或膀胱已經蓄積足量尿液卻不自覺，同樣可能導致心悸
  13. ^ See Obsessive–compulsive_spectrum#Tic_disorders（英语：Obsessive–compulsive_spectrum#Tic_disorders）
  14. ^ Elsevier BV曾經出版一篇文獻指出，未經治療的ADHD可能在往後的人生中直接或間接衍生出以下共伴疾病（已忽略重複項目）：吸菸、性成癮（包含：從事高風險性愛（英语：Risky sexual behavior）、罹患性感染疾病）。間接：體適能不足、醫療費用及就醫次數增加。極間接：糖尿病、高血壓。[216]
  15. ^ 「常見副作用」的定義為：在臨床試驗中，實驗組中至少5%的人出現此症狀，且在實驗組中出現此反應的比例為安慰組的兩倍。
  16. ^ 「較少見的副作用」的定義為：在臨床試驗中，實驗組中至少2%的人出現此症狀，且在實驗組中出現此反應的比例多於安慰組。
  17. ^ 舉例：一個三十公斤的服藥者每天不可服用超過60毫克的專思達
  18. ^ 延伸閱讀：腎上腺素受體、α2腎上腺素受體
  19. ^ 膠囊必須整顆與開水或其他液體一起吞服。其他注意事項請詳閱藥品說明書。[271]
  20. ^ 請注意（仿單標註）：
    • 除非經醫師評估後允許，否則在服用Clonidine期間切勿攝取酒精及其他與clonidine藥效相似皆會增加睡意的物質、藥物。
    • 不要在服用Clonidine期間駕車、操作機械或從事具危險性的活動，除非服藥者已明白且熟悉Clonidine對自己帶來的各種影響。
    • 避免讓自己脫水及中暑。
    clonidine常見的副作用為：
    1. 較低的血壓及心跳速率
    2. 想睡覺。 [275]
  21. ^ 舊名：amfebutamone
  22. ^ 中華民國中醫師公會全國聯合會將《Complementary Therapies in Medicine》翻譯為「醫學補充療法」
  23. ^ 即表示可附加在現有具備科學實證且能在統計學上達到顯著意義之有效改善症狀的醫學療法。

注释

參見

外部連結

维基文库中的相关原始文献：身心障礙者權利公約
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中樞神經刺激劑
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