注意力缺陷過動症之藥物原理及其相關議題

Pharmacotherapy of Attention-Deficit/Hyperactivity Disorder Using Methylphenidate: Mechanism of Action and Its Related Issues

本文乃是針對近年來有關注意力缺陷過動症（attention-deficit/hyperactivity disorder，簡稱ADHD）之藥物治療以及相關議題之文獻進行回顧，旨在瞭解治療ADHD的臨床第一線藥物，甲基芬尼特（methylphenidate），在大腦神經元化學訊息傳導之作用原理以及使用該藥物進行治療時所關注的相關議題，包括甲基芬尼特在神經藥物學上的特性、產生療效的實徵證據、副作用產生的可能機制、長期使用該藥物對未來物質濫用的影響，以及臨床上常見的第二線藥物之替代時機和這些第二線藥物在大腦神經元化學訊息傳導上的作用機制等。期盼藉由ADHD的神經生物學病理基礎、相關藥物的神經藥物學基本原理與衍生議題之探討，增進輔導ADHD學生的教師與家長對此等議題的知能和判斷能力。

This article reviews past studies on the pharmacotherapy of attention-deficit/hyperactivity disorder (ADHD) as treated with methylphenidate. It aims to examine the mechanism of action of methylphenidate and related clinical issues (including therapeutic effects, side effects, the possibility of substance abuse following long-term use, and potential second-line medications). By investigating the neurobiological basis of ADHD, the principles of neuropharmacology, and relevant clinical issues, the article aims to enhance the knowledge and understanding of teachers or parents involved in helping children with ADHD.