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注意力不足過動症的治療

一種經過科學實驗驗證的療法

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]。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病的症狀,已經證實為注意力不足過動症的有效附加療法英语add-on treatment[a][4][5][6][7][8][9][10]

注意力不足過動症患者甚至其家屬可能對自身或患者的問題存有否認心理,包括:高估自己的能力及低估自己的困難、並因此做出不合理的決定(為反對而反對地否認診斷,即便確實有需要仍拒絕接受學習及醫療上的協助、排斥旁人包括醫師、老師、父母與家人的幫忙等)。鼓勵患者甚至其家屬勇於面對注意力不足過動症將使注意力不足過動症的長期預後變得更為樂觀。[11][12][13][14]對於那些難以著眼於長遠報酬(報償、酬賞)的注意力不足過動症患者(傾向著眼於眼前立即回饋、追逐新奇感英语novelty seeking的注意力不足過動症患者),大量且持續的正向激勵可以增進患者的任務表現,注意力不足過動症的用藥亦有相同的功效。[15][16][17][18] 許多文獻及指引都表示,ADHD的治療(包含藥物治療)並非是要將患者們標準化(一致化)或是控制患者,而是一本教育的初衷,協助每一位患者發掘、發揚自己的優點、並避免缺點。[19][5][6]

臺灣兒童青少年精神醫學會發文指出,對於ADHD患者而言,應注意所接受的療法是否受到政府的密切監督以確保符合嚴謹的研究設計及是否奠基於嚴謹實證醫學科學證據、充分研究證據支持療效且符合台灣現行的法律規範;對於政府衛生醫療相關單位而言:應給予足夠資源,強化對弱勢家庭的支持,包括提升親職功能以及家族治療等,以便提供患者更完整有效的醫療模式[20][21]


1999年美國衛生署(NIH)所做的研究:MTA(多重治療模式研究)為期14個月的臨床研究結果[22][23]
治療模式 整體進步(單位:%百分比)
ADHD藥物+ADHD行為暨認知行為治療 (MTA模式)
68
ADHD藥物治療 (MTA模式)
56
ADHD行為治療 (MTA模式)
34
ADHD藥物治療
25
  • 【ADHD藥物治療 (MTA模式)】、【ADHD行為治療 (MTA模式)】與【ADHD藥物治療】,這三組治療模式對患者在許多領域應對能力的缺陷,例如:社交技巧、親子關係、情緒管理、課業表現等的改善程度幾乎一致。【ADHD藥物治療 (MTA模式)】+【ADHD行為治療 (MTA模式)】的改善效果則高於其他實驗組或其他實驗組的排列組合[24]
  • 【ADHD藥物治療 (MTA模式)】+【ADHD行為治療 (MTA模式)】所需的藥物劑量少於【ADHD藥物治療】或【ADHD藥物治療 (MTA模式)】。[24]
  • 藥物顯著壓抑用藥者的身高和體重的發展。[24]
  • 88%的ADHD完成了這項為期十四個月的臨床實驗、有4%的ADHD受制於藥物的副作用而離開[24]
  • 統計呈現出的平均進步分數無法反映每位受試者的真實情況。事實上,即便是【ADHD藥物治療 (MTA模式)】、【ADHD行為治療 (MTA模式)】中的受試者,每個受試者之間的進步幅度都不同。另外,有一些受試者無論是在四個組別的任意一組,其ADHD的症狀都獲得顯著改善。[24]
  • 上述四種治療型式都不是最佳的治療方案,依據患者的情況下判斷才是最好的選擇。[24]
  • 實驗僅表明了各治療模式持續14個月的效果。[24] 受試者在14個月後的自由意志不再受制於實驗的規定。因此這些人雖然在往後數十年仍定期接受MTA評估(非治療),但考量到他們之中有一些人即便在其他地方持續以藥物治療,但其藥物治療的方式不一定符合MTA的實驗規範,是故已經無法從定期長期追蹤評估的結果精準判斷上述四種模式的長期治療效果[24]。不過該定期長期追蹤評估的結果可用來判斷注意力不足過動症本身的病程和帶給患者的人生境遇。[24]
  • 【ADHD行為治療 (MTA模式)】包含27堂團體父母管理訓練課程、8堂個別父母管理訓練課程、為期八周的暑期ADHD治療課程、為期十二周的課堂ADHD行為治療課程與半互動的學習模式和十位ADHD專門教師的諮商課程。[25]
  • 【ADHD藥物治療】:普通的精神科門診型式[26][24]


多管齊下编辑

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[20]。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[27][28]。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[16][29]

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。[30][4] 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。[5] 藥物治療合併行為治療認知行為治療[31])已證實為當前最有效的注意力不足過動症治療方式。[32][11][33][34][35][35][36][37]

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。[33]」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。[38][4]: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。[39] 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[40][41][42][43](包含遭受網路霸凌或在網路上霸凌別人[44][45])。[46][47]

非藥物治療编辑

行為治療(MTA模式)编辑

 
父母管理訓練前(before)後(after)的效果对比[48][49]

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。)[6][50][51]

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。[52]

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。[53][54][55]

行為方面的治療 簡介
心理教育 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。[56][57][58]
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学习原理而使心理障碍得到矫正的。[59][60]

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)。

[51]

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。[19]

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]

[50]

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」。[64]
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。[65][25][24]
學校資源介入英语school-based interventions
-
社交技巧英语Social skills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[66][67]
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。 [68]環境的支持有利於注意力不足過動症的治療[69][70][71][72][73]
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。[74]
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。[75]
行為改正英语Behavior modification 證據表明具有一定益處。[66]
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「英语Otology、鼻、喉科醫師」一般開立「語言治療」的處方。[77]
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。[78][79]
正念療法

正念療法尚需更多研究來證明其有效性。[50]

婚姻諮商 [80]
職業諮商英语Career_counseling [80]
ADHD教練 [80]

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。[81][82][83][84][85][86]

例如:思覺失調症患者在疾病急性發作住院期間,給予藥物協助緩解正性症狀。病房中也會由專業人員,例如:精神科醫師、精神科護理師、臨床心理師、諮商心理師、職能治療師、精神科社工師等,帶領團體治療,或者給予個別治療。而在急性症狀緩解後,患者、家屬和醫療團隊一同討論復健計畫,例如到復健病房、日間留院或者工作坊,透過復健計畫,有效增加病識感英语Self-awareness(患者對於自身英语self-concept以及自身疾病的認識英语self-consciousness程度[87][88])、學習獨立生活能力英语independent living、改善家庭社會關係英语social relation[81][82]

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。[4]

認知行為治療(MTA模式)编辑

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[89][90]

  • 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。[91]

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。[92]

認知訓練编辑

青少年及成年编辑

《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。[4]

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[4]。除此之外增加「環境結構」[註 2]、學習分辨事情的緩急輕重[5]、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)

[95]

兒童编辑

《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) [19][96] 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。[19]: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[19]

課堂外的策略:

  1. 協助孩子找出在特定情境下出現的問題。[19]
  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。[19]
  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。[19]
  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。[19]
  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。[19]

家庭编辑

《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[97]。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。[19] 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。[19][98]

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[99][100][101]

家中的行為治療编辑

*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)。[102]
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[102]

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。[102]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[102]

  • 用「愛」來溝通
  • 傾聽與陪伴[106]
「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。[107]

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。[107]

充足的睡眠编辑

充足的睡眠能提升學習力與專注力,也能讓身體得到足夠的休養。正常的生長激素分泌有賴規律及足夠的睡眠[108][109]。研究指出,台灣孩子的睡眠時數相較其他國家,少了大約一個半小時[19][110][111]。足夠的睡眠能讓有ADHD的孩子更專注、更能自我控制 [112]。相形之下,睡眠不足連帶使得身體與精神狀況不佳,情緒較容易低落,形成惡性循環。[113][114][115] 注意力不足過動症往往直接導致患者「難以入睡」、「即便入睡,也難以持續多久」,這與注意力不足過動症所導致的「內在和外在的不安寧」[註 5]有關。[116][117]

治療ADHD或許能改善患者因ADHD之「內在和外在的不安寧」等症狀所引起的睡眠問題[118][119][120];同理,改善睡眠品質或許能改善ADHD的症狀。[120][121][116] 研究指出,「規律」的睡眠有助於提升睡眠品質,良好的睡眠品質會有較好的精神且能改善注意力不足過動症的症狀[116][122][123]

運動编辑

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 6][4][5][6][7][8][9][10][124]

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[4][5][6][7][9][10][125]

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。[7]

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。[7]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。[7]

飲食编辑

健康及營養均衡的飲食(食物飲用水飲料)是保持身心健康的基礎,從而減少疾病(例如:慢性病)的生成。[126][127][128]

截至2019年7月,沒有任何科學證據顯示、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[129][130][131][132][133][134]

飲食的調整可能對少部份的ADHD兒童有幫助[135],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[136],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[136],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[136]。2014年發表的文獻也發現排除饮食在治療ADHD上的成效有限[137],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[138]

鐵、鎂及碘等礦物質的攝取可能可以改善ADHD的症狀[139],有一些證據指出身體組織內的成份過低和其ADHD症狀有關[140],不過一般不建議用補充鋅礦物質的方式來治療ADHD,只有在有鋅缺乏英语zinc deficiency的地區(幾乎只會在開發中國家)才建議補充鋅礦物質[141]。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[142]。另有證據指出Omega3-脂肪酸能提供對於病情些許的改善[143][144],不過也有證據指出其功效非常有限[145][146],因此不建議用Omega3-脂肪酸來取代醫學治療[147][148]

一些研究發現,人工食用色素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。[149][150]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。[150][136][151] 針對這樣的疑慮,英国欧洲联盟已經發布相關食品管理措施。[152]

對於某些食物的食物過敏食物不耐症,可能會惡化少數孩子既有的ADHD症狀。[137]


音樂编辑

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[159]、增加注意力不足過動症及自閉症亞斯伯格症(ASD)患者的腦部特定神經連結並使得預後更加樂觀[160],然而音樂治療的有效性尚需更多相關論文支持[161][162]

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。[4]:117-118

教育疗法编辑

教育療法則是學校老師利用教育學理論,讓孩子在教室中能保有最佳的表現。[86]

Eric (2001)所做的一项对老师进行的调查,該調查研究了「有『哪些课堂方法』正在被实施」,并能帮助提高注意力困难儿童上课时的注意力。教师们发现活动是最有效的方法。在授課的过程中提供活动,可以提供學生持续的活动输入。 [163]

教育療法為患者開創出一個穩定、有結構的學習環境。[86]

  • 有效率地傳達學校的預期(例如:家庭作業、個人獨立任務、其他任務等)
  • 有效率地傳達指示。
  • 有效率地從一個活動切換到另一個活動。
  • 完善教室的規劃(包含:教材與其他東西)
  • 依據課程難度,安排適當的進度,避免囫圇吞棗,也讓學生不會產生強大的挫折感。
  • 在作業/任務過程中與完成後都給予學生適當的建議與評語。
  • 耐心的陪伴。
  • 適當的任務時間長度。
  • 減少環境噪音
  • 將課程視覺化,並加強課程的特色與用途等,讓學生感到新奇與有趣。
  • 角色扮演

[86][164]

心理師编辑

心理師能依照醫師的醫囑實行適用於患者和其家庭所需的心理治療,也為患者進行心理衡鑑。[86][82]

多媒體编辑

特殊教育编辑

針對注意力不足過動症的學生,可以用「前事後因」方法進行教育,可在個案某個不恰當的行為出現前就調整改變外在因素(前因英语Antecedent_(behavioral_psychology)),或是透過獎懲後果的方式,引導個案改變行為[169]

善用「前事後因」方法:
  1. 前因英语Antecedent_(behavioral_psychology):在個案某個不恰當的行為出現前就調整改變外在因素。
  2. 透過教育,針對個案某個不恰當的行為進行改變。
  3. 後果英语operant conditioning:透過獎懲的方式,引導個案改變行為。
介入反應評估 (RTI)

學習障礙、情緒行為障礙個案的介入反應評估英语Response_to_intervention一般來說分為三個層次:從「一般預防」到「特殊預防」。依據行為改變術的第一、二、三層原則,給予個案所需的導引:

第一層:基本介入。基本介入的策略對其他沒有ADHD的孩子也有用。

  • 提供結構:建立班級常規。
  • 傳授技巧:遇到A的時候就要做B。以及諸如:建立生活結構的技巧、增進或彌補工作記憶的技巧、做功課的技巧。
  • 團體回饋:設計有趣的課程並在學生參與課程的過程中提供充分的酬賞,如:讚美等正增強。

第二層:加強介入。對於接受基本介入後,反應效果有限的個案,提供小團體式加強。

  • 調整作業份量、延後作業繳交期限、調整學生的階段性作業進度目標。
  • 設立小志工團體,例如:引介志工、安親媽媽協助。
  • 強化家庭與學校之間的連結(聯繫),例如:家庭訪視、指派家長協助事項等、提供每週進度給家長。
  • 課後輔導加強、課後留下來自習。

第三層: 第一層、第二層介入無效,通常是比較嚴重,問題較多的個案。

  • 運用個別化教育計畫(IEP)建構個人化的學習。
  • 針對個案之特定、重要問題處理、研究個案的成功標準,例如:不是作業都要交,而是有繳交作業就好,一旦能持續做到繳交作業,再慢慢調整標準。安排ADHD教練、提供個別差異化、客製化的視覺提示等。
  • 善用《增強檢核表》,尋找特定的獎勵。

[170][171][172][173]

多元智能理論

多元智能理論認為,對於普通教育無明顯效果的小朋友,特殊教育老師會去發掘小朋友的長處、調整環境的限制、透過小組討論、作中學英语Hands-on learning等方式來讓學生發光發熱,重新拾獲信心。當孩子注意力改善,建立安全的學習環境後,基於事物的好奇的本性,孩子能重新選擇自己的擅長的地方,當他的優點能被看到,孩子就能自動繼續前進學習。[174][175][176][177][178]

奇美醫院獎斐忠政認為,一些家長把特教老師當做免費的補習老師,要求老師全力訓練ADHD兒童跟一般孩子一樣,並不合適。[179]

職能治療编辑

職能治療方面的文献建议,在教室中采用动态座位系统英语Active_sitting(參見彈性座位的教室英语flexible seating_classrooms)是可以改善学生感觉调节和注意力的一种方法。[180][181][182]

職能治療師能協助患者運用職能治療技巧讓生活變得更有組織、規律、計畫、對於時間有更有效的管理[183]。職能治療師也會協助「評估患者技能」、「安排患者團體治療與專屬個人的治療計畫」,[82] 並幫助患者增進社交技巧與日常生活的自理能力。[82]

社會工作编辑

社會工作師(社工師)會為患者的家庭提供支援(family support)、言語諮商、提供家務管理的建議、協助經濟上的困難、與其他方面的支援。 [82] 社會工作師會協助患者與其家庭取得需要的資源和社會福利與政府暨民間的支援服務以利患者康復並維持身心的健康並且獲得良好的生活品質,藉此讓患者及其家庭在人際關係財務休閒個人生活職業居住都獲得保障與成功。[82]

時間管理编辑

許多時間管理中的工具可以幫助ADHD患者,例如艾森豪威尔法則[184]優先次序矩陣英语Priority Matrix尽管去做番茄工作法等。

正念療法编辑

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。[185] 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。[186] 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。 [50]

體外三叉神經微電流刺激系統编辑

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。[187]

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。[187] 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。[187] 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)。[187] 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。[187] 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。[187]

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。[187][188][189]

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。[190]

其他编辑

         

ADHD的治療方式圖解:

  1. 遊戲治療 [來源請求]
  2. 藥物治療
  3. 生物反饋 [來源請求]
  4. 箱庭療法希伯來語טיפול_בשולחן_חול [來源請求]
  5. 利用行事曆軟體(例如:Windwos CalendarGoogle Calendar)協助患者有效管理時間和生活事務。

藥物治療编辑

      參見:ADHD的治療藥物、藥品一覽表注意力不足過動症多重治療模式研究§藥物治療

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。 [191][192][註 7]

  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。 [193][194][195][196][197]

  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。[references 1][references 2]

ADHD有時可能出現忘記吃藥的情形[註 8],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。[213][214] 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)」[215]。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。[216][217][218][219]

中樞神經刺激劑[註 9]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[206][220]

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[221]。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[221]。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[221]

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 10],但是興奮劑類藥物確實有幫助患者們保持平靜的效果。[222][206] 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。[223]

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。[224][225]

一般來說,以藥物治療ADHD的效果相當顯著。 [32][34] 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。[32][226] 文獻另指出,針對ADHD的個人化醫療英语Personalized medicine可能包含較新的ADHD藥物配方、組合。[227]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)[228],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[229]

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。[33][230][231][232][233][234][235][236][237][238][39]

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。[230]

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。[33]」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。[239][4]

 
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[240]

中樞神經刺激劑编辑

中樞神經刺激劑藥物是治療ADHD的藥物選擇之一。[241][242] 中樞神經刺激劑至少能在14個月內,改善部分ADHD的症狀。[243][244][245]

一些家長和老師回報哌甲酯似乎能改善ADHD的症狀。[244][243][246] 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。[247]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。[248][249][250] 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。[251] 中樞神經刺激劑必須定期暫停使用或降低藥劑量英语drug holiday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。[252][253] 長期以「遠高於治療用劑量」的中樞神經刺激劑治療ADHD,可能會導致成癮物質依賴[254][255] 然而,若ADHD未被妥善治療,患者在往後容易出現物質濫用行為問題英语conduct disorders的風險。[254] 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。[256][257][254]

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[258]

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 11] 短:3.5小時左右 約服用後30分鐘
Adderall 右旋苯丙胺左旋苯丙胺
  • 短效型:4-5小時[263]
  • 長效型:10-12小時[263]
  • 短效型:30-60分鐘[263]
  • 長效型:60-90分鐘或更短[263]
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

[4][269][270][271][272]

  • 必須避免於藥物作用期間攝取乙醇,因為這兩種物質很可能會導致血漿中的methylphenidate濃度急速升高[259]

利他能[272]、利長能[269]、專思達[271]、安保美喜錠[273] ,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。[274][275][276]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,實現個人化醫療英语Personalized medicine[277][sources 1][sources 2][sources 3][sources 4][sources 5][sources 6]

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[314][315]。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。[19][316][317]:722[316]

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[11]。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。[4][5][318]

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。[319]

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。[231][320][321][322]

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 12][323][324][325],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[325][326](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[327][328];食欲降低也可能讓服藥者在空腹的時候卻不覺得,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胃潰瘍[329])。[330][323][331][332][333][334][335][336][337][338]

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。[323][323][339]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[340][341][342][343][344]

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 13]體重下降頭痛抖動抽动综合症尿液滯留[註 14][345][346][347][348][349][註 15][350][351][352];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。[323][353][354][355][353][354][356] 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[237](陳錦宏醫師指出,發生意外藥物成癮酒精成癮風險約達到50%)[197][註 16][358]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[359]

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。[231][320][360] 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) [361]

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 17][註 18]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。[231][362][363][364][365][366][367][368]

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。[369][370]

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%[371]。然而研究初步發現,胎兒子宮接觸到哌甲酯,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。[261]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。[261]

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[372]

 
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编辑

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 19]
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有效的劑量範圍英语Effective_dose_(pharmacology)為:36 - 108 毫克/每天 [387]

[388] 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)。[388]
  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。)[389]

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)[310][311][312][313]

非中樞神經刺激劑编辑

數種非中樞神經刺激劑,例如:阿托莫西汀可樂定安非他酮胍法辛英语guanfacine,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。[241][245][390] 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。[391] 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。[392] 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。[256] 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。[391] 截至2015年6月 (2015-06),ADHD藥物的長期療效尚未被完全評定。[257][393]

禮來公司(Eli Lilly)的思銳(Strattera),有效成份為阿托莫西汀[394],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。[394] 「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)」。[395]

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[394]。(副作用產生與否因人而異)[394]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[396]。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。[397][398] 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 [399][400][401][402]。服用者建議定期追蹤監測心律血壓肝功能英语liver function[403],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[403]

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。[404][405][406][407][408]

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英语off-label use的方式處方之。[409][410][411][412][413][414]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。[415]

可樂定胍法新英语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 20] [362][416][417][418][419][420]

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。[421]
  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。[362][416][418][419]
藥品學名 藥物類別(屬性) 作用時間 備註
阿托莫西汀 (思銳)[註 21] 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 [402][423][424][425]
  • 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[225]
可樂定 [註 22] 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 [427][428][429][430][431]
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[427][434]
  • 已經可在中國大陸取得。[435]

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。[27][436][437]

安非他酮國際非專利藥品名稱Bupropion[註 23])是菸鹼拮抗劑英语Nicotinic antagonist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。[241][438][439][440][441]

第一線非中樞神經刺激劑编辑

思銳(Strattera)仿單上的建議劑量[394]
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[442]
  • 備註:
  1. 建議劑量與種族無關。[394]
  2. 肝腎功能不全的患者的服用劑量應低於建議劑量[394](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。[394]
  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[395]

研究中藥物编辑


妥瑞氏症编辑

中醫编辑

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」[456]。然而記者會中提供的新聞稿並未對此敘述提出文獻證明,以供查證[456]

中華民國中醫師公會全國聯合會另表示,2010 年發表於《醫學中的替代醫學療法英语Complementary Therapies in Medicine[註 24](一個專門紀載替代醫學[註 25]的期刊)的一個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,且能減少復發率英语relapse。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)、足部腎經太谿)、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。」[457][不可信賴的邊緣學說來源][需要可靠醫學來源]

參考文獻编辑

  1. ^ Shaw M, Hodgkins P, Caci H, Young S, Kahle J, Woods AG, Arnold LE. A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Med. 2012-09-04, 10: 99. PMC 3520745. PMID 22947230. doi:10.1186/1741-7015-10-99. 
  2. ^ 2.0 2.1 Wolraich, M.; Brown, L.; Wolraich, RT.; Brown, G.; Brown, M.; Dupaul, HM.; Earls, TG.; Feldman, B.; 等. Steering Committee on Quality Improvement Management. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. November 2011, 128 (5): 1007–22. PMC 4500647. PMID 22003063. doi:10.1542/peds.2011-2654. 5b: For elementary school-aged children (6–11 years of age), ...
    Action statement 5c: For adolescents (12–18 years of age), ...
    Similar to the recommendations from the previous guideline, stimulant medications are highly effective for most children in reducing core symptoms of ADHD.44 One selective norepinephrine-reuptake inhibitor (atomoxetine45,46) and 2 selective α2-adrenergic agonists (extended-release guanfacine47,48 and extended-release clonidine49) have also demonstrated efficacy in reducing core symptoms. Because norepinephrine-reuptake inhibitors and α2-adrenergic agonists ... Compared with stimulant medications that have an effect size [effect size = (treatment mean — control mean)/control SD] of approximately 1.0,50 the effects of the nonstimulants are slightly weaker; atomoxetine has an effect size of approximately 0.7, and extended-release guanfacine and extended-release clonidine also have effect sizes of approximately 0.7.
     
  3. ^ 3.0 3.1 Attention-deficit-hyperactivity-disorder-in-children-and-adolescents-overview-of-treatment-and-prognosis. UpToDate. [2018-03-17]. For school-aged children (≥6 years) and adolescents with ADHD, ... 
  4. ^ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 高淑芬. 找回專注力:成人ADHD全方位自助手冊. 台北: 心靈工坊. 2016-05-09 [2016-12-12]. ISBN 9789863570592 (中文(台灣)‎). 
  5. ^ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Edward M. Hallowell & John J. Ratey. 分心不是我的錯(增訂版):正確診療ADD,重建有計畫的生活方式 Driven to Distraction. 遠流出版. 2015-09-01 [2017-06-27]. ISBN 978-957-32-7700-2. 
  6. ^ 6.0 6.1 6.2 6.3 6.4 Edward M. Hallowell, M.D.; John J. Ratey, M.D. 《分心也有好成績》,. 丁凡譯. 台北: 遠流出版社. 2006 [2016-12-09]. ISBN 9573259311. 
  7. ^ 7.0 7.1 7.2 7.3 7.4 7.5 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. 
  8. ^ 8.0 8.1 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. 
  9. ^ 9.0 9.1 9.2 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. 
  10. ^ 10.0 10.1 10.2 Rommel, Anna-Sophie; Halperin, Jeffrey M.; Mill, Jonathan; Asherson, Philip; Kuntsi, Jonna. Protection from genetic diathesis in ADHD: Possible complementary roles of exercise. Journal of American Academy of Child and Adolescent Psychiatry. 2017-02-16, 52 (9): 900–910. PMC 4257065. PMID 23972692. doi:10.1016/j.jaac.2013.05.018 –通过PubMed Central. 
  11. ^ 11.0 11.1 11.2 TSCAP. 青少年ADHD的治療-一系統性回顧. Tscap.org.tw. [2016-12-27]. doi:10.1001/jama.2016.5453. (原始内容存档于2016-11-29). 
  12. ^ Singh, Ilina. Boys Will Be Boys: Fathersʼ Perspectives on ADHD Symptoms, Diagnosis, and Drug Treatment. Harvard Review of Psychiatry (Ovid Technologies (Wolters Kluwer Health)). 2003, 11 (6): 308–316. ISSN 1067-3229. doi:10.1080/10673220390264221. 
  13. ^ Barkley, Russell. Taking charge of ADHD : the complete, authoritative guide for parents. New York: The Guilford Press. 2013: 152-153. ISBN 978-1-4625-0789-4. OCLC 825196454. 
  14. ^ Chan, Eugenia; Fogler, Jason M.; Hammerness, Paul G. Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents. JAMA (American Medical Association (AMA)). 2016-05-10, 315 (18): 1997. ISSN 0098-7484. doi:10.1001/jama.2016.5453. 
  15. ^ Chandler DJ, Waterhouse BD, Gao WJ. New perspectives on catecholaminergic regulation of executive circuits: evidence for independent modulation of prefrontal functions by midbrain dopaminergic and noradrenergic neurons. Front. Neural Circuits. 2014-05, 8: 53. PMC 4033238. PMID 24904299. doi:10.3389/fncir.2014.00053. 
  16. ^ 16.0 16.1 Malenka RC, Nestler EJ, Hyman SE. Chapters 10 and 13. (编) Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience 2nd. New York: McGraw-Hill Medical. 2009: 266, 315, 318–323. ISBN 9780071481274. Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention. 
  17. ^ Sethi, Arjun; Voon, Valerie; Critchley, Hugo D; Cercignani, Mara; Harrison, Neil A. A neurocomputational account of reward and novelty processing and effects of psychostimulants in attention deficit hyperactivity disorder. Brain : a journal of neurology (Oxford University Press (OUP)). 2018-03-13, 141 (5): 1545–1557. ISSN 0006-8950. PMC 5917772. PMID 29547978. doi:10.1093/brain/awy048. 
  18. ^ 台大醫院精神醫學部住院醫師李律恩 摘譯. 以神經計算模型探討注意力不足過動症之酬賞與追求新奇歷程,以及中樞神經興奮劑治療反應 (PDF). 兒童青少年精神醫學通訊. 2018-12-03, 17 (3): 07 [2018-12-25]. (原始内容 (PDF)存档于2018-12-25). 
  19. ^ 19.00 19.01 19.02 19.03 19.04 19.05 19.06 19.07 19.08 19.09 19.10 19.11 19.12 19.13 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. 
  20. ^ 20.0 20.1 20160728公聽會-建議新聞稿. 臺灣兒童青少年精神醫學會. 2016-07-28. (原始内容存档于2017-12-15). 
  21. ^ 注意力不足過動症與妥瑞氏症的非藥物治療 (PDF). 台灣兒童青少年精神醫學會 官方網站. 精神醫學通訊 Child & Adolescent Psychiatry Newsletter Vol.16 No 1. Spring 2017. 台灣兒童青少年精神醫學會. 2017 [2017-06-07]. (原始内容存档 (PDF)于2017-12-13). 
  22. ^ Multimodal treatment of Attention Deficit Hyperactivity Disorder (MTA) Study.. National Institute of Mental Health of the United State of America. (tertiary source). 2009-11 [April 22nd, 2017.]. (原始内容存档于2017-04-22).  |archiveurl=|archive-url=只需其一 (帮助); |accessdate=|access-date=只需其一 (帮助); |archivedate=|archive-date=只需其一 (帮助);
  23. ^ Authors, No. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Tr... - PubMed. NCBI. 1999-12-11 [2017-04-22]. (原始内容存档于2017-05-04). 
  24. ^ 24.00 24.01 24.02 24.03 24.04 24.05 24.06 24.07 24.08 24.09 24.10 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. 
  25. ^ 25.0 25.1 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. 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. 
  26. ^ 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. doi:10.1097/chi.0b013e31819c23d0. 
  27. ^ 27.0 27.1 Wilens TE, Spencer TJ. Understanding attention-deficit/hyperactivity disorder from childhood to adulthood. Postgrad Med. 2010-09, 122 (5): 97–109. PMC 3724232. PMID 20861593. doi:10.3810/pgm.2010.09.2206. 
  28. ^ Bidwell LC, McClernon FJ, Kollins SH. Cognitive enhancers for the treatment of ADHD. Pharmacol. Biochem. Behav. August 2011, 99 (2): 262–274. PMC 3353150. PMID 21596055. doi:10.1016/j.pbb.2011.05.002. 
  29. ^ Modesto-Lowe V, Chaplin M, Soovajian V, Meyer A. Are motivation deficits underestimated in patients with ADHD? A review of the literature. Postgrad Med. 2013, 125 (4): 47–52. PMID 23933893. doi:10.3810/pgm.2013.07.2677. Behavioral studies show altered processing of reinforcement and incentives in children with ADHD. These children respond more impulsively to rewards and choose small, immediate rewards over larger, delayed incentives. Interestingly, a high intensity of reinforcement is effective in improving task performance in children with ADHD. Pharmacotherapy may also improve task persistence in these children. ... Previous studies suggest that a clinical approach using interventions to improve motivational processes in patients with ADHD may improve outcomes as children with ADHD transition into adolescence and adulthood. 
  30. ^ 蔣丙煌; 陳快樂; 國立臺灣大學醫學院附設醫院精神醫學部; 張雍敏、鄭淑心、賴淑玲、傅悅娟、張景瑞、侯育銘、郭約瑟、張君威、鄧惠文、陳嘉新、紀雪雲、黃雅文、連玉如、連盈如、吳其炘; 高淑芬&陳劭芊. 注意力不足過動症 (PDF). 衛生福利部精神疾病衛教叢書 02 First. Taipei: 中華民國衛生福利部. 2015-06: 19-20. ISBN 9789860454154. (原始内容存档于2017-02-19) (中文(台灣)‎). 
  31. ^ Pharmacotherapy-for-adult-attention-deficit-hyperactivity-disorder. UpToDate. [2018-03-17]. (原始内容存档于2018-03-17). The addition of a targeted cognitive-behavioral therapy to a partially effective first-line medication would be a reasonable alternative to medication. 
  32. ^ 32.0 32.1 32.2 Chan, Eugenia; Fogler, Jason M.; Hammerness, Paul G. Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents. JAMA. 2016, 315 (18): 1997. ISSN 0098-7484. doi:10.1001/jama.2016.5453. 
  33. ^ 33.0 33.1 33.2 33.3 TSCAP. 20160728公聽會-台灣兒童青少年精神醫學會新聞稿. Tscap.org.tw. [2016-12-27]. (原始内容存档于2017-03-05). 
  34. ^ 34.0 34.1 顏正芳. 孩子和家長接受專業醫療協助的權利,是需要被維護的. 台灣兒童青少年精神醫學會. 2016/05 [2017-02-27]. (原始内容存档于2016-11-29). 
  35. ^ 35.0 35.1 TSCAP. 臺灣兒童青少年精神醫學會新聞稿20160603. Tscap.org.tw. [2016-12-27]. (原始内容存档于2016-11-30). 
  36. ^ TSCAP. 新聞稿20160412-回應質疑注意力不足過動症之診斷、藥物治療等議題. Tscap.org.tw. [2016-12-27]. (原始内容存档于2016-11-30). 
  37. ^ 翁士恒. ADHD 臨床現場的分裂與對話:以ICF為參照的反思. 還孩子做自己行動聯盟. 2017-03-13 [2017-06-24]. (原始内容存档于2018-03-08) (中文). ADHD不只是心智功能與神經結構出現問題,還包括了病者的自我調適、家庭支持系統、鄰人功能與居家環境的功能與障礙。這些包含身體功能、活動參與與環境功能的整體,才是一個完整的疾病經驗(Lived experience of illness)。  |archiveurl=|archive-url=只需其一 (帮助); |accessdate=|access-date=只需其一 (帮助); |archivedate=|archive-date=只需其一 (帮助)
  38. ^ 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: 1680-1681. 2018-09-19 [2018-07-16] (中文). 
  39. ^ 39.0 39.1 Chang, Zheng; Quinn, Patrick D.; Hur, Kwan; Gibbons, Robert D.; Sjölander, Arvid; Larsson, Henrik; D’Onofrio, Brian M. Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes. JAMA psychiatry (American Medical Association (AMA)). 2017-06-01, 74 (6): 597. ISSN 2168-622X. PMC 5539840. PMID 28492937. doi:10.1001/jamapsychiatry.2017.0659. 
  40. ^ Liu, Tai-Ling; Guo, Nai-Wen; Hsiao, Ray C.; Hu, Huei-Fan; Yen, Cheng-Fang. Relationships of bullying involvement with intelligence, attention, and executive function in children and adolescents with attention-deficit/hyperactivity disorder. Research in Developmental Disabilities (Elsevier BV). 2017, 70: 59–66. ISSN 0891-4222. doi:10.1016/j.ridd.2017.08.004. 
  41. ^ Yeh, Yi-Chun; Huang, Mei-Feng; Wu, Yu-Yu; Hu, Huei-Fan; Yen, Cheng-Fang. Pain, Bullying Involvement, and Mental Health Problems Among Children and Adolescents With ADHD in Taiwan. Journal of attention disorders (SAGE Publications). 2017-08-24: 108705471772451. ISSN 1087-0547. PMID 28836888. doi:10.1177/1087054717724514. 
  42. ^ Hu, Huei-Fan; Chou, Wen-Jiun; Yen, Cheng-Fang. Anxiety and depression among adolescents with attention-deficit/hyperactivity disorder: The roles of behavioral temperamental traits, comorbid autism spectrum disorder, and bullying involvement. The Kaohsiung journal of medical sciences (Elsevier BV). 2016, 32 (2): 103–109. ISSN 1607-551X. PMID 26944330. doi:10.1016/j.kjms.2016.01.002. 
  43. ^ Chou, Wen-Jiun; Liu, Tai-Ling; Yang, Pinchen; Yen, Cheng-Fang; Hu, Huei-Fan. Bullying Victimization and Perpetration and Their Correlates in Adolescents Clinically Diagnosed With ADHD. Journal of attention disorders (SAGE Publications). 2014-11-17, 22 (1): 25–34. ISSN 1087-0547. PMID 25403369. doi:10.1177/1087054714558874. 
  44. ^ Yen, Cheng-Fang; Chou, Wen-Jiun; Liu, Tai-Ling; Ko, Chih-Hung; Yang, Pinchen; Hu, Huei-Fan. Cyberbullying among male adolescents with attention-deficit/hyperactivity disorder: Prevalence, correlates, and association with poor mental health status. Research in developmental disabilities (Elsevier BV). 2014, 35 (12): 3543–3553. ISSN 0891-4222. PMID 25241113. doi:10.1016/j.ridd.2014.08.035. 
  45. ^ Chou, Wen-Jiun; Liu, Tai-Ling; Hu, Huei-Fan; Yen, Cheng-Fang. Suicidality and its relationships with individual, family, peer, and psychopathology factors among adolescents with attention-deficit/hyperactivity disorder. Research in Developmental Disabilities (Elsevier BV). 2016, 53–54: 86–94. ISSN 0891-4222. doi:10.1016/j.ridd.2016.02.001. 
  46. ^ Unnever, James D.; Cornell, Dewey G. Bullying, Self-Control, and Adhd. Journal of Interpersonal Violence (SAGE Publications). 2003, 18 (2): 129–147. ISSN 0886-2605. doi:10.1177/0886260502238731. 
  47. ^ YouTube上的20180811自閉症青少年親職講座,始於13分14秒(中文)
  48. ^ Barkley, RA; Edwards, G; Laneri, M; Fletcher, K; Metevia, L, The efficacy of problem-solving communication training alone, behavior management training alone, and their combination for parent-adolescent conflict in teenagers with ADHD and ODD., Journal of consulting and clinical psychology, 2001, 69 (6): 926–41, ISSN 0022-006X, PMID 11777120 
  49. ^ Chronis, Andrea M.; Chacko, Anil; Fabiano, Gregory A.; Wymbs, Brian T.; Pelham, Jr., William E. Enhancements to the Behavioral Parent Training Paradigm for Families of Children with ADHD: Review and Future Directions. Clinical Child and Family Psychology Review (Springer Nature). 2004, 7 (1): 1–27. ISSN 1096-4037. doi:10.1023/b:ccfp.0000020190.60808.a4. 
  50. ^ 50.0 50.1 50.2 50.3 50.4 Psychotherapy for adults with ADHD. UpToDate. [2018-02-24]. (原始内容存档于2018-02-24). 
  51. ^ 51.0 51.1 Attention deficit hyperactivity disorder in children and adolescents overview of treatment and prognosis. UpToDate. [2018-02-24]. (原始内容存档于2018-02-24). 
  52. ^ Turkington, Carol; Harris, Joseph. attention deficit hyperactivity disorder (ADHD). The Encyclopedia of the Brain and Brain Disorders. Infobase Publishing: 47. 2009. ISBN 978-1-4381-2703-3 –通过Google Books. 
  53. ^ Fabiano GA, Pelham WE, Coles EK, Gnagy EM, Chronis-Tuscano A, O'Connor BC. "A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder".. Clincal Psychology Rev. (systematic review). 2009-03, 29 (2): 129–140. PMID 19131150. doi:10.1016/j.cpr.2008.11.001. 
  54. ^ Kratochvil CJ, Vaughan BS, Barker A, Corr L, Wheeler A, Madaan V. Review of pediatric attention deficit/hyperactivity disorder for the general psychiatrist. Psychiatr. Clin. North Am. 2009-03, 32 (1): 39–56. PMID 19248915. doi:10.1016/j.psc.2008.10.001. 
  55. ^ Guidelines May Have Helped Curb ADHD Diagnoses in Preschoolers. MedlinePlus.gov (tertiary source). HealthDay. 2016-11-15 [2017-01]. (原始内容存档于2016-12-25). The guidelines, issued by the American Academy of Pediatrics (AAP), called for a standardized approach to diagnosis, and recommended behavior therapy -- not drugs -- as the first-line therapy for preschoolers.  |archiveurl=|archive-url=只需其一 (帮助); |accessdate=|access-date=只需其一 (帮助); |archivedate=|archive-date=只需其一 (帮助)
  56. ^ Xia, J; Merinder, LB; Belgamwar, MR. Psychoeducation for schizophrenia.. The Cochrane database of systematic reviews. 2011-06-15, (6): CD002831. ISSN 1469-493X. PMC 417090757139 请检查|pmc=值 (帮助). PMID 21678337. doi:10.1002/14651858.CD002831.pub2. 
  57. ^ Xia J, Merinder LB, Belgamwar MR. Psychoeducation for schizophrenia. Cochrane Database Syst Rev. 2011;(6):CD002831
  58. ^ Tay, Kay Chai Peter; Seow, Chuen Chai Dennis; Xiao, Chunxiang; Lee, Hui Min Julian; Chiu, Helen FK; Chan, Sally Wai-Chi. Structured interviews examining the burden, coping, self-efficacy, and quality of life among family caregivers of persons with dementia in Singapore. Dementia. 2016-03-01, 15 (2): 204–220. ISSN 1471-3012. doi:10.1177/1471301214522047 (英语). 
  59. ^ O'Leary, K. Daniel, and G. Terence Wilson. Behaviour Therapy: Application and Outcome, 7-12. Englewood Cliffs, NJ: Prentice-Hall, 1975. Print.
  60. ^ Leary, K. Behavior therapy : application and outcome. Englewood Cliffs, N.J: Prentice-Hall. 1987. ISBN 978-0-13-073875-2. OCLC 14213289. 
  61. ^ Biederman, Joseph; Mick, Eric; Fried, Ronna; Wilner, Nicole; Spencer, Thomas J.; Faraone, Stephen V. Are stimulants effective in the treatment of executive function deficits? Results from a randomized double blind study of OROS-methylphenidate in adults with ADHD. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology (Elsevier BV). 2011, 21 (7): 508–515. ISSN 0924-977X. PMID 21303732. doi:10.1016/j.euroneuro.2010.11.005. 
  62. ^ 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. 
  63. ^ Barkley, R. A.; Murphy, K. R. Impairment in Occupational Functioning and Adult ADHD: The Predictive Utility of Executive Function (EF) Ratings Versus EF Tests. Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists (Oxford University Press (OUP)). 2010-03-02, 25 (3): 157–173. ISSN 0887-6177. PMC 2858600. PMID 20197297. doi:10.1093/arclin/acq014. 
  64. ^ 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. PMID 9631340. 
  65. ^ 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. 
  66. ^ 66.0 66.1 Mikami, Amori Yee. The importance of friendship for youth with attention-deficit/hyperactivity disorder. Clin Child Fam Psychol Rev. 2010-06, 13 (2): 181–98. PMC 2921569. PMID 20490677. doi:10.1007/s10567-010-0067-y. 
  67. ^ ADHD, CHADD – The National Resource on. CHADD. Social Skills in Adults with ADHD. [2018-06-14]. (原始内容存档于2017-12-22). 
  68. ^ Daley, D; Van Der Oord, S; Ferrin, M; Cortese, S; Danckaerts, M; Doepfner, M; Van den Hoofdakker, BJ; Coghill, D; Thompson, M; Asherson, P; Banaschewski, T; Brandeis, D; Buitelaar, J; Dittmann, RW; Hollis, C; Holtmann, M; Konofal, E; Lecendreux, M; Rothenberger, A; Santosh, P; Simonoff, E; Soutullo, C; Steinhausen, HC; Stringaris, A; Taylor, E; Wong, ICK; Zuddas, A; Sonuga-Barke, EJ. Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder.. Journal of child psychology and psychiatry, and allied disciplines. 2017-10-30. PMID 29083042. doi:10.1111/jcpp.12825. 
  69. ^ Positive Parenting. NIH News in Health. 2017-08-31 [2017-11-01]. (原始内容存档于2017-11-07). 
  70. ^ Can Adults With ADHD Really Change?. Psychology Today. 2016-06-01 [2017-11-02]. 
  71. ^ Fabiano, Gregory A. Father participation in behavioral parent training for ADHD: Review and recommendations for increasing inclusion and engagement.. Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) (American Psychological Association (APA)). 2007, 21 (4): 683–693. ISSN 1939-1293. PMID 18179340. doi:10.1037/0893-3200.21.4.683. 
  72. ^ Thijssen, J; Vink, G; Muris, P; de Ruiter, C. The Effectiveness of Parent Management Training—Oregon Model in Clinically Referred Children with Externalizing Behavior Problems in The Netherlands. Child psychiatry and human development (Springer Nature). 2016-06-15, 48 (1): 136–150. ISSN 0009-398X. PMC 5243899. PMID 27306883. doi:10.1007/s10578-016-0660-5. 
  73. ^ 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. PMID 28025755. doi:10.1007/s10802-016-0238-5. 
  74. ^ Montgomery, Charles. Role of dynamic group therapy in psychiatry. Advances in Psychiatric Treatment. January 2002, 8 (1): 34–41. doi:10.1192/apt.8.1.34. (原始内容存档于2018-04-01). 
  75. ^ 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. 
  76. ^ 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. 
  77. ^ 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). 
  78. ^ Baer, D.M.; Wolf, M.M. & Risley, T.R. Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis. 1968, 1 (1): 91–97. PMC 1310980. PMID 16795165. doi:10.1901/jaba.1968.1-91. 
  79. ^ 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"
  80. ^ 80.0 80.1 80.2 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). 
  81. ^ 81.0 81.1 Haines, Alina; Perkins, Elizabeth; Evans, Elizabeth A.; McCabe, Rhiannah. Multidisciplinary team functioning and decision making within forensic mental health. Mental Health Review (Brighton, England) (Emerald). 2018-09-10, 23 (3): 185–196. ISSN 1361-9322. PMC 6201820. PMID 30464703. doi:10.1108/mhrj-01-2018-0001. 
  82. ^ 82.0 82.1 82.2 82.3 82.4 82.5 82.6 What is a Multidisciplinary Team?. The College of Psychiatrists of Ireland. [2019-08-18]. (原始内容存档于2019-08-19). 
  83. ^ Coghill, David; Seth, Sarah. Effective management of attention-deficit/hyperactivity disorder (ADHD) through structured re-assessment: the Dundee ADHD Clinical Care Pathway. Child and Adolescent Psychiatry and Mental Health (Springer Nature). 2015-11-19, 9 (1). ISSN 1753-2000. PMC 4652349. PMID 26587055. doi:10.1186/s13034-015-0083-2. 
  84. ^ Recommendations - Attention deficit hyperactivity disorder: diagnosis and management - Guidance. NICE. 2018-03-14 [2019-08-19]. 
  85. ^ 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. PMID 19881936. 
  86. ^ 86.0 86.1 86.2 86.3 86.4 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. 
  87. ^ Marková, IS; Berrios, GE. The meaning of insight in clinical psychiatry.. The British journal of psychiatry : the journal of mental science. 1992, 160: 850–60. ISSN 0007-1250. PMID 1617369. 
  88. ^ 李舒中. 精神疾病「病識感」(insight)的社會分析: 一個民族誌的觀察 (PDF). 考古人類學刊. 2010. (原始内容 (PDF)存档于2017). 
  89. ^ 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. 
  90. ^ Solanto, Mary. Cognitive-behavioral therapy for adult ADHD : targeting executive dysfunction. New York: Guilford Press. 2011. ISBN 978-1-4625-0963-8. OCLC 663954234. 
  91. ^ 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). 
  92. ^ 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)
  93. ^ Melby-Lervåg M, Hulme C. Is working memory training effective? A meta-analytic review. Dev Psychol. February 2013, 49 (2): 270–91. PMID 22612437. doi:10.1037/a0028228.  已忽略未知参数|citeseerx= (帮助)
  94. ^ Sonuga-Barke, E; Brandeis, D; Holtmann, M; Cortese, S. Computer-based Cognitive Training for ADHD: A Review of Current Evidence. Child and Adolescent Psychiatric Clinics of North America. October 2014, 23 (4): 807–824. PMID 25220088. doi:10.1016/j.chc.2014.05.009. 
  95. ^ 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. 
  96. ^ 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). 
  97. ^ 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。"
  98. ^ 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。"
  99. ^ 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). 
  100. ^ 100.0 100.1 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. 
  101. ^ 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]. 
  102. ^ 102.0 102.1 102.2 102.3 Behavior Therapy - ADHD - NCBDDD. CDC. 2017-04-19 [2017-11-01]. (原始内容存档于2017-12-09). 
  103. ^ 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. 
  104. ^ 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. 
  105. ^ 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. 
  106. ^ 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). 
  107. ^ 107.0 107.1 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). 
  108. ^ Chen MY, Wang EK, Jeng YJ. Adequate sleep among adolescents is positively associated with health status and health-related behaviors.. BMC Public Health. 2006, 6: 59. PMC 1447528. PMID 16524482. doi:10.1186/1471-2458-6-59. 
  109. ^ Tai SY, Wang WF, Yang YH. Current status of sleep quality in Taiwan: a nationwide walk-in survey.. Ann Gen Psychiatry. 2015, 14: 36. PMC 4630925. PMID 26535047. doi:10.1186/s12991-015-0078-7. 
  110. ^ Taiwan study: How much sleep do children need?. BBC. 2014-05-04 [2017-04-24]. (原始内容存档于2017-04-24). 
  111. ^ Yen CF, Ko CH, Yen JY, Cheng CP. The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia among Taiwanese adolescents.. Sleep. 2008, 31 (11): 1515–25. PMC 2579980. PMID 19014071. 
  112. ^ Tsai MH, Hsu JF, Huang YS. Sleep Problems in Children with Attention Deficit/Hyperactivity Disorder: Current Status of Knowledge and Appropriate Management.. Curr Psychiatry Rep. 2016, 18 (8): 76. PMID 27357497. doi:10.1007/s11920-016-0711-4. 
  113. ^ Gau SS, Chiang HL. Sleep problems and disorders among adolescents with persistent and sub-threshold attention-deficit/hyperactivity disorders.. Sleep. 2009, 32 (5): 671–9. PMC 2675902. PMID 19480234. 
  114. ^ Gau SS, Soong WT, Merikangas KR. Correlates of sleep-wake patterns among children and young adolescents in Taiwan.. Sleep. 2004, 27 (3): 512–9. PMID 15164908. 
  115. ^ Huang YS, Chen NH, Li HY, Wu YY, Chao CC, Guilleminault C. Sleep disorders in Taiwanese children with attention deficit/hyperactivity disorder.. J Sleep Res. 2004, 13 (3): 269–77. PMID 15339263. doi:10.1111/j.1365-2869.2004.00408.x. 
  116. ^ 116.0 116.1 116.2 Hiscock, H.; Sciberras, E.; Mensah, F.; Gerner, B.; Efron, D.; Khano, S.; Oberklaid, F. Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: randomised controlled trial. BMJ. 2015, 350 (jan20 1): h68–h68. ISSN 1756-1833. doi:10.1136/bmj.h68. 
  117. ^ Kooij, SJ; Bejerot, S; Blackwell, A; Caci, H; Casas-Brugué, M; Carpentier, PJ; Edvinsson, D; Fayyad, J; Foeken, K; Fitzgerald, M; Gaillac, V; Ginsberg, Y; Henry, C; Krause, J; Lensing, MB; Manor, I; Niederhofer, H; Nunes-Filipe, C; Ohlmeier, MD; Oswald, P; Pallanti, S; Pehlivanidis, A; Ramos-Quiroga, JA; Rastam, M; Ryffel-Rawak, D; Stes, S; Asherson, P. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry. 2010-09-03, 10: 67. PMC 2942810. PMID 20815868. doi:10.1186/1471-244X-10-67.   
  118. ^ Stein MA, Weiss M, Hlavaty L. ADHD treatments, sleep, and sleep problems: complex associations.. Neurotherapeutics. 2012, 9 (3): 509–17. PMC 3441938. PMID 22718078. doi:10.1007/s13311-012-0130-0. 
  119. ^ Hvolby A. Associations of sleep disturbance with ADHD: implications for treatment.. Atten Defic Hyperact Disord. 2015, 7 (1): 1–18. PMC 4340974. PMID 25127644. doi:10.1007/s12402-014-0151-0. The interrelationships are further complicated by the use of psychostimulant medications to treat ADHD, which impair sleep in some patients (Spruyt and Gozal 2011) but paradoxically (Bradley 1937) improve sleep in others via a calming effect (Jerome 2001; Kinsbourne 1973; Kooij et al. 2001; Kratochvil et al. 2005). 
  120. ^ 120.0 120.1 ADHD, Sleep and Sleep Disorders | CHADD. [2018-06-07]. (原始内容存档于2018-02-01). 
  121. ^ Corkum, Penny; Tannock, Rosemary; Moldofsky, Harvey. Sleep Disturbances in Children With Attention‐Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 1998, 37 (6): 637–646. ISSN 0890-8567. doi:10.1097/00004583-199806000-00014. 
  122. ^ Penny Williams. A Good Night’s Sleep Helps Children with ADHD. HealthLine news. 2015-03-05 [2017-05-02]. (原始内容存档于2016-04-12). 
  123. ^ Chamorro M, Lara JP, Insa I, Espadas M, Alda-Diez JA. [Evaluation and treatment of sleep problems in children diagnosed with attention deficit hyperactivity disorder: an update of the evidence].. Rev Neurol. 2017, 64 (9): 413–421. PMID 28444684. CONCLUSIONS: It is important to evaluate sleep in children who present symptoms suggestive of ADHD, since problems during sleep can play a causal role or exacerbate the clinical features of ADHD. Correct evaluation and treatment of sleep disorders increase the family's and the child's quality of life and can lessen the severity of the symptoms of ADHD. 
  124. ^ Prescribing exercise for adults. UpToDate. [2018-07-15]. (原始内容存档于2018-07-16).  |accessdate=|access-date=只需其一 (帮助)
  125. ^ Suwabe, Kazuya; Byun, Kyeongho; Hyodo, Kazuki; Reagh, Zachariah M.; Roberts, Jared M.; Matsushita, Akira; Saotome, Kousaku; Ochi, Genta; Fukuie, Takemune; Suzuki, Kenji; Sankai, Yoshiyuki; Yassa, Michael A.; Soya, Hideaki. Rapid stimulation of human dentate gyrus function with acute mild exercise. Proceedings of the National Academy of Sciences of the United States of America (Proceedings of the National Academy of Sciences). 2018-09-24: 201805668. ISSN 0027-8424. PMID 30249651. doi:10.1073/pnas.1805668115. 
  126. ^ Author:Graham A Colditz, MD, DrPH; Section Editor:David Seres, MD; Deputy Editor:Lisa Kunins, MD. Healthy diet in adults. UpToDate. [2019-08-23]. 
  127. ^ Author:Graham A Colditz, MD, DrPH; Section Editor:David Seres, MD; Deputy Editor:Lisa Kunins, MD. Patient education: Diet and health (Beyond the Basics). UpToDate. [2019-08-23]. 
  128. ^ The doctors and editors at UpToDate. Patient education: Diet and health (The Basics). UpToDate. [2019-08-23]. 
  129. ^ Wolraich, Mark L. The Effect of Sugar on Behavior or Cognition in Children. JAMA (American Medical Association (AMA)). 1995-11-22, 274 (20): 1617. ISSN 0098-7484. doi:10.1001/jama.1995.03530200053037. The meta-analytic synthesis of the studies to date found that sugar does not affect the behavior or cognitive performance of children. The strong belief of parents may be due to expectancy and common association. However, a small effect of sugar or effects on subsets of children cannot be ruled out.(JAMA. 1995;274:1617-1621) 
  130. ^ American Academy of Pediatrics. Allergies and Hyperactivity. HealthyChildren.org. 2018-07-13 [2018-07-13]. (原始内容存档于2017-12-21). 
  131. ^ Hyperactivity and sugar: MedlinePlus Medical Encyclopedia. MedlinePlus. 2018-07-09 [2018-07-13]. (原始内容存档于2017-12-23).  
    • In some cases, a special diet of foods without artificial flavors or colors works for a child, because the family and the child interact in a different way when the child eliminates these foods. These changes, not the diet itself, may improve the behavior and activity level.
    • Refined (processed) sugars may have some effect on children's activity. Refined sugars and carbohydrates enter the bloodstream quickly. Therefore, they cause rapid changes in blood sugar levels. This may make a child become more active.
    • Several studies have shown a link between artificial colorings and hyperactivity. On the other hand, other studies do not show any effect. This issue is yet to be decided.  参数|quote=值左起第7位存在換行符 (帮助)
  132. ^ Busting the Sugar-Hyperactivity Myth. WebMD. 2018-04-05 [2018-07-13]. (原始内容存档于2018-02-22). 
  133. ^ Hyperactivity and sugar: MedlinePlus Medical Encyclopedia. MedlinePlus. 2018-07-09 [2018-07-13]. (原始内容存档于2017-12-23). Recommendations There are many reasons to limit the sugar a child has other than the effect on activity level.
    • A diet high in sugar is a major cause of tooth decay.
    • High-sugar foods tend to have fewer vitamins and minerals. These foods may replace foods with more nutrition. High-sugar foods also have extra calories that can lead to obesity.
    • Some people have allergies to dyes and flavors. If a child has a diagnosed allergy, talk to a dietitian.
    • Add fiber to your child's diet to keep blood sugar levels more even. For breakfast, fiber is found in oatmeal, shredded wheat, berries, bananas, whole-grain pancakes. For lunch, fiber is found in whole-grain breads, peaches, grapes, and other fresh fruits.
    • Provide "quiet time" so that children can learn to calm themselves at home.
    • Talk to your health care provider if your child cannot sit still when other children of his or her age can, or cannot control impulses.  参数|quote=值左起第16位存在換行符 (帮助)
  134. ^ Dietz, William. Nutrition : what every parent needs to know. Elk Grove Village, IL: American Academy of Pediatrics. 2012. ISBN 978-1-58110-631-2. OCLC 767736204. 
  135. ^ Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. January 2012, 51 (1): 86–97. PMID 22176942. doi:10.1016/j.jaac.2011.10.015. 
  136. ^ 136.0 136.1 136.2 136.3 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... 
  137. ^ 137.0 137.1 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. 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. 
  138. ^ 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. 
  139. ^ Konikowska K, Regulska-Ilow B, Rózańska D. The influence of components of diet on the symptoms of ADHD in children. Rocz Panstw Zakl Hig. 2012, 63 (2): 127–134. PMID 22928358. 
  140. ^ Arnold LE, DiSilvestro RA. Zinc in attention-deficit/hyperactivity disorder. Journal of child and adolescent psychopharmacology. 2005, 15 (4): 619–27. PMID 16190793. doi:10.1089/cap.2005.15.619. 
  141. ^ 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. 
  142. ^ 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. 
  143. ^ 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 请检查|pmc=值 (帮助). PMID 28741625. doi:10.1038/npp.2017.160. 
  144. ^ 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. 
  145. ^ Omega Fish oils don't improve school children's reading skills or memory, study finds. birmingham.ac.uk. 2018-03-02 [2018-03-14]. 
  146. ^ Montgomery, Paul; Spreckelsen, Thees F.; Burton, Alice; Burton, Jennifer R.; Richardson, Alexandra J. van Wouwe, Jacobus P., 编. Docosahexaenoic acid for reading, working memory and behavior in UK children aged 7-9: A randomized controlled trial for replication (the DOLAB II study). PLOS ONE (Public Library of Science (PLoS)). 2018-02-20, 13 (2): e0192909. ISSN 1932-6203. doi:10.1371/journal.pone.0192909. 
  147. ^ Bloch MH, Qawasmi A. Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2011-10, 50 (10): 991–1000. PMC 3625948. PMID 21961774. doi:10.1016/j.jaac.2011.06.008. 
  148. ^ 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. PMID 27555775. doi:10.2147/NDT.S68652. 
  149. ^ NIMH. Attention Deficit Hyperactivity Disorder (Easy-to-Read). National Institute of Mental Health. 2013 [17 April 2016]. (原始内容存档于14 April 2016).  已忽略未知参数|df= (帮助)
  150. ^ 150.0 150.1 Millichap JG, Yee MM. The diet factor in attention-deficit/hyperactivity disorder. Pediatrics. February 2012, 129 (2): 330–7. PMID 22232312. doi:10.1542/peds.2011-2199. (原始内容存档于11 September 2015).  已忽略未知参数|df= (帮助)
  151. ^ Tomaska LD, Brooke-Taylor S. Food Additives – General. (编) Motarjemi Y, Moy GG, Todd EC. Encyclopedia of Food Safety 3 1st. Amsterdam: Elsevier/Academic Press: 449–54. 2014. ISBN 978-0-12-378613-5. OCLC 865335120. 
  152. ^ 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)
  153. ^ Schnoll R, Burshteyn D, Cea-Aravena J. Nutrition in the treatment of attention-deficit hyperactivity disorder: a neglected but important aspect. Applied Psychophysiology and Biofeedback. March 2003, 28 (1): 63–75. PMID 12737097. doi:10.1023/A:1022321017467. 
  154. ^ Krummel DA, Seligson FH, Guthrie HA. Hyperactivity: is candy causal?. Critical Reviews in Food Science and Nutrition. 1996, 36 (1–2): 31–47. PMID 8747098. doi:10.1080/10408399609527717. 
  155. ^ Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. January 2012, 51 (1): 86–97.e8. PMC 4321798. PMID 22176942. doi:10.1016/j.jaac.2011.10.015. 
  156. ^ Food coloring ban in the UK but usage continues for USA. BioHealthBase BRC Team. 
  157. ^ Modernising the Rules on Food Additives and Labelling of Azo Dyes. FLEXNEWS: Business News for the Food Industry. Global Data Systems. 9 July 2008. 
  158. ^ Kleinman RE, Brown RT, Cutter GR, Dupaul GJ, Clydesdale FM. A research model for investigating the effects of artificial food colorings on children with ADHD. Pediatrics. June 2011, 127 (6): e1575–84. PMID 21576306. doi:10.1542/peds.2009-2206. 
  159. ^ 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]. 
  160. ^ 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). 
  161. ^ 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. PMID 26441688. doi:10.3389/fpsyt.2015.00127. 
  162. ^ 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]. 
  163. ^ Eric (2001)
  164. ^ SULKES.STEPHEN. Attention-Deficit/Hyperactivity Disorder (ADD, ADHD) - Pediatrics. MSD Manual Professional Edition. 2019-08-15 [2019-08-19] (英语). 
  165. ^ Jenks, Susan. ADHD patients play video games as part of treatment. USA Today. 9 March 2006. 
  166. ^ Butnik S.M. Neurofeedback in adolescents and adults with attention deficit hyperactivity disorder. Journal of Clinical Psychology. 2005, 61 (5): 621–625. PMID 15723361. doi:10.1002/jclp.20124. 
  167. ^ Shaw R.; Grayson A.; Lewis V. Inhibition, ADHD, and computer games: The inhibitory performance of children and ADHD on computerized tasks and games. Journal of Attention Disorders. 2000, 8 (4): 160–168. PMID 16110046. doi:10.1177/1087054705278771. 
  168. ^ Tolchinsky A.; Jefferson, S.D. Problematic video game play in a college sample and its relationship to time management skills and Attention-Deficit/Hyperactivity disorder symptomology. Cyberpsychology, Behavior, and Social Networking. 2011, 14 (9): 489–496. PMID 21288135. doi:10.1089/cyber.2010.0315. 
  169. ^ 國立臺灣師範大學特殊教育學系; 教育部特殊教育工作小組. 中華民國注意力缺陷過動症學生學校特殊教育輔導手冊 (PDF). — (台灣). 2001-06 [2018-07-19]. (原始内容 (PDF)存档于2018-07-19). 
  170. ^ 錡寶香. 特殊需求兒童的語言學習問題與語言教學 (PDF). 國立台北教育大學特教系. (原始内容 (PDF)存档于2018-12-15). 
  171. ^ 許婷婷. 採納教學後反應評準對學習障礙鑑定的 影響:區辨效度和發生率 (PDF). 曾世杰. 國立臺東大學特殊教育學系碩士班 碩士論文. 2011-06. (原始内容 (PDF)存档于2018-12-15). 
  172. ^ 張世彗. 學習障礙學生的教學與趨向 (PDF). 國小特殊教育. 2009 年 6 月, 第 47 期: 1-13 頁. (原始内容 (PDF)存档于2018-12-15). 
  173. ^ 陳姿諭/彰化縣管嶼國小資源班教師. 從介入反應模式(RTI)談普通班教師與特教教師之協同合作. 全國特殊教育資訊網. 2018-12-15 [2018-12-15] (中文). 
  174. ^ Gordon, Lynn Melby. "Gardner, Howard (1943–)." Encyclopedia of Human Development. Ed. Neil J. Salkind. Vol. 2. Thousand Oaks, CA: SAGE Reference, 2006. 552-553. Gale Virtual Reference Library. Web. 27 Oct. 2014.
  175. ^ McKenzie, Walter. Multiple intelligences and instructional technology. Eugene, Or: International Society for Technology in Education. 2005. ISBN 1-56484-188-X. OCLC 712621303. 
  176. ^ Gardner, Howard. Interpersonal Communication amongst Multiple Subjects: A Study in Redundancy. Experimental Psychology. 2002. 
  177. ^ Gilman, Lynn. The Theory of Multiple Intelligences. Indiana University. 2012 [2008] [14 November 2012]. (原始内容存档于25 November 2012). 
  178. ^ Gottfredson, L. S. Social Consequences of Group Differences in Cognitive Ability (Consequencias sociais das diferencas de grupo em habilidade cognitiva). (编) Flores-Mendoza, C. E.; Colom, R. Introducau a psicologia das diferencas individuais. ArtMed Publishers. 2006: 433–456. ISBN 978-8536314181. 
  179. ^ 獎斐忠政. 對事情不感興趣怎麼辦?. Facebook. [2018-07-28]. (原始内容存档于2018-7-29) (中文(台灣)‎). 
  180. ^ Kimball, L; Randolph, ML; Diel, D; Rowland, K. Planning, coaching, education: a big payoff.. Aspen's advisor for nurse executives. 1999, 14 (4): 9–12. ISSN 0883-9743. PMID 10067466. 
  181. ^ L, Kimball; A, Eunice. PubMed. NCBI. 1999-10-28 [2017-10-24]. (原始内容存档于2018-01-25). 
  182. ^ Pfeiffer B, Henry A, Miller S, Witherell S. Effectiveness of Disc 'O' Sit cushions on attention to task in second-grade students with attention difficulties.. Am J Occup Ther. 2008, 62 (3): 274–81. PMID 18557003. 
  183. ^ Occupational Therapy for Children With ADHD. WebMD. 2017-05-10 [2017-08-09]. (原始内容存档于2017-08-09). 
  184. ^ Rollins, Katy. The Motivational Matrix. ADDitude. 2013-10-27 [2019-01-27]. 
  185. ^ 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. 
  186. ^ 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. 
  187. ^ 187.0 187.1 187.2 187.3 187.4 187.5 187.6 FDA permits marketing of first medical device for treatment of ADHD. U.S. Food and Drug Administration. 2019-04-19 [2019-08-13]. 
  188. ^ 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 请检查|pmc=值 (帮助). PMID 30768393. doi:10.1016/j.jaac.2018.11.013. 
  189. ^ 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]. 
  190. ^ 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. 
  191. ^ 191.0 191.1 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. PMID 24342384. doi:10.1016/j.jaac.2013.09.001. 
  192. ^ 192.0 192.1 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=|access-date=只需其一 (帮助)
  193. ^ 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) 
  194. ^ 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). 
  195. ^ 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(台灣)‎). 
  196. ^ 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(台灣)‎). 
  197. ^ 197.0 197.1 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。 
  198. ^ Arnold, L. Eugene; Hodgkins, Paul; Caci, Hervé; Kahle, Jennifer; Young, Susan. Effect of Treatment Modality on Long-Term Outcomes in Attention-Deficit/Hyperactivity Disorder: A Systematic Review. PLoS ONE. [2017-05-15]. PMID 25714373. doi:10.1371/journal.pone.0116407. 
  199. ^ Millichap JG. Chapter 9: Medications for ADHD. (编) Millichap JG. Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD 2nd. New York, USA: Springer. 2010: 112. ISBN 9781441913968.
    Table 9.2 Dextroamphetamine formulations of stimulant medication
    Dexedrine [Peak:2–3 h] [Duration:5–6 h] ...
    Adderall [Peak:2–3 h] [Duration:5–7 h]
    Dexedrine spansules [Peak:7–8 h] [Duration:12 h] ...
    Adderall XR [Peak:7–8 h] [Duration:12 h]
    Vyvanse [Peak:3–4 h] [Duration:12 h]
     
  200. ^ Huang YS, Tsai MH. Long-term outcomes with medications for attention-deficit hyperactivity disorder: current status of knowledge. CNS Drugs. 2011-07, 25 (7): 539–554. PMID 21699268. doi:10.2165/11589380-000000000-00000. 
  201. ^ Arnold LE, Hodgkins P, Caci H, Kahle J, Young S. Effect of treatment modality on long-term outcomes in attention-deficit/hyperactivity disorder: a systematic review. PLoS ONE. 2015-02, 10 (2): e0116407. PMC 4340791. PMID 25714373. doi:10.1371/journal.pone.0116407. The highest proportion of improved outcomes was reported with combination treatment (83% of outcomes). Among significantly improved outcomes, the largest effect sizes were found for combination treatment. The greatest improvements were associated with academic, self-esteem, or social function outcomes. 
  202. ^ Dexedrine Prescribing Information (PDF). United States Food and Drug Administration. Amedra Pharmaceuticals LLC. 2013-10 [2013-11-04]. (原始内容存档 (PDF)于2016-03-04). 
  203. ^ Adderall IR Prescribing Information (PDF). United States Food and Drug Administration. Teva Pharmaceuticals USA, Inc. 2015-10 [2016-05-18]. (原始内容存档 (PDF)于2016-04-18). 
  204. ^ Adderall XR Prescribing Information (PDF). United States Food and Drug Administration. Shire US Inc. 2013-12 [2013-12-30]. (原始内容存档 (PDF)于2013-12-30). 
  205. ^ The amphetamine withdrawal syndrome. Department of Health. [2017-05-09]. (原始内容存档于2017-02-08). 
  206. ^ 206.0 206.1 206.2 NIMH » Attention Deficit Hyperactivity Disorder. NIMH » Home. [2018-07-21]. (原始内容存档于2016-12-25). Stimulants. The most common type of medication used for treating ADHD is called a “stimulant.” Although it may seem unusual to treat ADHD with a medication that is considered a stimulant, it works because it increases the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention. Under medical supervision, stimulant medications are considered safe. However, there are risks and side effects, especially when misused or taken in excess of the prescribed dose.For example, stimulants can raise blood pressure and heart rate and increase anxiety. Therefore, a person with other health problems, including high blood pressure, seizures, heart disease, glaucoma, liver or kidney disease, or an anxiety disorder should tell their doctor before taking a stimulant.  |accessdate=|access-date=只需其一 (帮助)
  207. ^ Overview of palpitations in adults. UpToDate. [2018-08-14]. (原始内容存档于2018-08-14). 
  208. ^ Approach to the child with palpitations. UpToDate. [2018-08-14]. (原始内容存档于2018-08-14). 
  209. ^ 209.0 209.1 Treatment of hypertension in asthma and COPD. UpToDate. 2016-02-01 [2017-11-02]. (原始内容存档于2017-11-07). 
  210. ^ Pharmacology of drugs used to treat attention deficit hyperactivity disorder in children and adolescents. UpToDate. [2018-09-12]. Clonidine may be useful in overaroused, easily frustrated, highly active, or aggressive individuals [3]. Although there are few randomized controlled trials with multiple drugs, the addition of clonidine to stimulant therapy may help offset some of the common stimulant side effects. 
  211. ^ Pliszka, Steven. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 2007, 46 (7): 894–921. ISSN 0890-8567. PMID 17581453. doi:10.1097/chi.0b013e318054e724. 
  212. ^ 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] 
  213. ^ 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. 
  214. ^ 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]. 
  215. ^ Stevens, Jonathan R.; Wilens, Timothy E.; Stern, Theodore A. Using Stimulants for Attention-Deficit/Hyperactivity Disorder: Clinical Approaches and Challenges. The Primary Care Companion for CNS Disorders. 2013, 15 (2). ISSN 2155-7772. PMC 3733520. PMID 23930227. doi:10.4088/PCC.12f01472. 
  216. ^ Young, Joel L. Individualizing Treatment for Adult ADHD: An Evidence-Based Guideline. Medscape. 2010 [2016-06-19]. (原始内容存档于2015-05-08). 
  217. ^ 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.
     
  218. ^ Kessler, S. Drug therapy in attention-deficit hyperactivity disorder. Southern Medical Journal. 1996, 89 (1): 33–38. ISSN 0038-4348. PMID 8545689. doi:10.1097/00007611-199601000-00005. 
  219. ^ Kienle, Gunver S; Kiene, Helmut. Clinical judgement and the medical profession. Journal of Evaluation in Clinical Practice. 2018-12-14, 17 (4) [2018-12-14]. PMID 20973873. doi:10.1111/j.1365-2753.2010.01560.x. 
  220. ^ 顏正芳. 注意力不足過動症(ADHD)的評估和治療. 高雄市立楠梓特殊教育學校 (www.nzsmr.kh.edu.tw/). [2018-03-15]. (原始内容存档于2018-03-15).  |archiveurl=|archive-url=只需其一 (帮助); |archivedate=|archive-date=只需其一 (帮助)
  221. ^ 221.0 221.1 221.2 管制藥品層層把關,防濫用成癮. 藥物食品安全週報. 衛生福利部食品藥物管理署. 2018/10/19 [2019-01-04]. (原始内容存档于2019-01-04) (中文). 
  222. ^ 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. 
  223. ^ 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. 
  224. ^ 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。」
  225. ^ 225.0 225.1 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. 
  226. ^ 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. 
  227. ^ 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. 
  228. ^ 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. 
  229. ^ 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 
  230. ^ 230.0 230.1 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. 
  231. ^ 231.0 231.1 231.2 231.3 Abuse, National Institute on Drug. Stimulant ADHD Medications: Methylphenidate and Amphetamines. (原始内容存档于2017-07-10). 
  232. ^ 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. 
  233. ^ 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. 
  234. ^ 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. 
  235. ^ 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. 
  236. ^ 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. 
  237. ^ 237.0 237.1 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. 
  238. ^ 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. 
  239. ^ 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). 
  240. ^ Stephen V Faraone. Attention deficit hyperactivity disorder and premature death. The Lancet. 2015-02-25 [2017-08-11]. doi:10.1016/S0140-6736(14)61822-5. 
  241. ^ 241.0 241.1 241.2 Wigal SB. Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults. CNS Drugs. 2009,. 23 Suppl 1: 21–31. PMID 19621975. doi:10.2165/00023210-200923000-00004. 
  242. ^ 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. 
  243. ^ 243.0 243.1 Mayes R, Bagwell C, Erkulwater J. ADHD and the rise in stimulant use among children. Harvard Review of Psychiatry. 2008, 16 (3): 151–66. PMID 18569037. doi:10.1080/10673220802167782. 
  244. ^ 244.0 244.1 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. 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 
  245. ^ 245.0 245.1 Castells X, Ramos-Quiroga JA, Bosch R, Nogueira M, Casas M. Castells X, 编. Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults. Cochrane Database Syst. Rev. 2011, (6): CD007813. PMID 21678370. doi:10.1002/14651858.CD007813.pub2. 
  246. ^ Storebø OJ, Ramstad E, Krogh HB, Nilausen TD, Skoog M, Holmskov M, 等. Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). The Cochrane Database of Systematic Reviews. November 2015, 11 (11): CD009885. PMID 26599576. doi:10.1002/14651858.CD009885.pub2. 
  247. ^ Ruiz-Goikoetxea M, Cortese S, Aznarez-Sanado M, Magallón S, Alvarez Zallo N, Luis EO, de Castro-Manglano P, Soutullo C, Arrondo G. Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews. January 2018, 84: 63–71. PMID 29162520. doi:10.1016/j.neubiorev.2017.11.007. 
  248. ^ Hart H, Radua J, Nakao T, Mataix-Cols D, Rubia K. Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/hyperactivity disorder: exploring task-specific, stimulant medication, and age effects. JAMA Psychiatry. February 2013, 70 (2): 185–98. PMID 23247506. doi:10.1001/jamapsychiatry.2013.277. 
  249. ^ 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. PMID 24107764. doi:10.4088/JCP.12r08287. 
  250. ^ 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. 
  251. ^ 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. 
  252. ^ van de Loo-Neus GH, Rommelse N, Buitelaar JK. To stop or not to stop? How long should medication treatment of attention-deficit hyperactivity disorder be extended?. European Neuropsychopharmacology. August 2011, 21 (8): 584–99. PMID 21530185. doi:10.1016/j.euroneuro.2011.03.008. 
  253. ^ 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)
  254. ^ 254.0 254.1 254.2 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 
  255. ^ Oregon Health & Science University. Black box warnings of ADHD drugs approved by the US Food and Drug Administration. Portland, Oregon: United States National Library of Medicine. 2009 [17 January 2014]. (原始内容存档于8 September 2017). 
  256. ^ 256.0 256.1 Kooij SJ, Bejerot S, Blackwell A, Caci H, Casas-Brugué M, Carpentier PJ, 等. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry. September 2010, 10: 67. PMC 2942810. PMID 20815868. doi:10.1186/1471-244X-10-67. 
  257. ^ 257.0 257.1 Kiely B, Adesman A. What we do not know about ADHD… yet. Current Opinion in Pediatrics. June 2015, 27 (3): 395–404. PMID 25888152. doi:10.1097/MOP.0000000000000229. In addition, a consensus has not been reached on the optimal diagnostic criteria for ADHD. Moreover, the benefits and long-term effects of medical and complementary therapies for this disorder continue to be debated. These gaps in knowledge hinder the ability of clinicians to effectively recognize and treat ADHD. 
  258. ^ Patient education: Treatment of attention deficit hyperactivity disorder in children (Beyond the Basics). UpToDate. [2019-01-04]. 
  259. ^ 259.0 259.1 Methylphenidate: Drug information. UpToDate. [2018-07-26]. (原始内容存档于2018-07-26). 
  260. ^ 260.0 260.1 RITALIN- methylphenidate hydrochloride tablet. DailyMed. 2019-05-16 [2019-09-03]. 
  261. ^ 261.0 261.1 261.2 261.3 261.4 Huybrechts, Krista F.; Bröms, Gabriella; Christensen, Lotte Brix; Einarsdóttir, Kristjana; Engeland, Anders; Furu, Kari; Gissler, Mika; Hernandez-Diaz, Sonia; Karlsson, Pär; Karlstad, Øystein; Kieler, Helle; Lahesmaa-Korpinen, Anna-Maria; Mogun, Helen; Nørgaard, Mette; Reutfors, Johan; Sørensen, Henrik Toft; Zoega, Helga; Bateman, Brian T. Association Between Methylphenidate and Amphetamine Use in Pregnancy and Risk of Congenital Malformations. JAMA psychiatry (American Medical Association (AMA)). 2018-02-01, 75 (2): 167. ISSN 2168-622X. PMC 5838573. PMID 29238795. doi:10.1001/jamapsychiatry.2017.3644. 
  262. ^ 262.0 262.1 262.2 Methylphenidate: Drug information. UpToDate. [2018-09-09]. Proton Pump Inhibitors: May increase the absorption of Methylphenidate. Specifically, proton pump inhibitors may interfere with the normal release of drug from the extended-release capsules (Ritalin LA brand), which could result in both increased absorption (early) and decreased delayed absorption. Risk C: Monitor therapy 
  263. ^ 263.0 263.1 263.2 263.3 ADHD Medication Chart. Accredited Continuing Education Courses for Mental Health and Psychology Counselors and CME Conferences. [2018-08-19]. (原始内容存档于2018-02-03). 
  264. ^ 264.0 264.1 264.2 264.3 Ben Amor, L; Sikirica, V; Cloutier, M; Lachaine, J; Guerin, A; Carter, V; Hodgkins, P; van Stralen, J. Combination and switching of stimulants in children and adolescents with attention deficit/hyperactivity disorder in quebec.. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent. 2014, 23 (3): 157–66. ISSN 1719-8429. PMC 4197516. PMID 25320609. 
  265. ^ 265.0 265.1 265.2 265.3 Dextroamphetamine and amphetamine: Drug information. UpToDate. [2018-09-09]. 
  266. ^ 266.0 266.1 RITALIN LA- methylphenidate hydrochloride capsule, extended release. DailyMed. 2019-01-31 [2019-09-03]. 
  267. ^ 衛生福利部中央健康保險署 公告. 衛生福利部中央健康保險署. 衛生福利部中央健康保險署. 2017-02-06 [2017-04-10]. (原始内容存档于2017-04-10). 
  268. ^ 「藥品給付規定」修正規定 (PDF). 衛生福利部中央健康保險署. 衛生福利部中央健康保險署. 2017-02-06 [2017-04-10]. (原始内容存档 (PDF)于2017-04-10). 
  269. ^ 269.0 269.1 Label of Ritalin LA (PDF). Novartis. 2015 [2017-01]. (原始内容存档 (PDF)于2017-08-30). 
  270. ^ Label of Ritalin LA. Novartis Pharmaceuticals Corporation. 2017-01-05 [2017-01]. (原始内容存档于2017-03-26). Ritalin LA 10, 20, 30, 40, and 60 mg capsules provide in a single dose the same amount of methylphenidate as dosages of 5, 10, 15, 20, or 30 mg of Ritalin tablets given b.i.d. 
  271. ^ 271.0 271.1 Label of Concerta (PDF). concerta.net. Jassen Cilag. 2013 [2017-01]. (原始内容 (PDF)存档于2017-01-17). 
  272. ^ 272.0 272.1 Label of Ritalin. DailyMed. Novartis. 2017-01-05 [2017-03]. (原始内容存档于2017-03-20). 
  273. ^ Apotex Incorporation., 安保美喜錠 10 毫克 衛署藥輸字第 025016 號, (编) 鴻汶醫藥實業有限公司, Information for the patient (PDF), Canada, 2006-03-27 [2017-03-19], (原始内容存档 (PDF)于2009-11-22) 
  274. ^ Lopez, F; Silva, R; Pestreich, L; Muniz, R, Comparative efficacy of two once daily methylphenidate formulations (Ritalin LA and Concerta) and placebo in children with attention deficit hyperactivity disorder across the school day., Paediatric drugs, 2003, 5 (8): 545–55, ISSN 1174-5878, PMID 12895137, While both Ritalin LA and Concerta were shown to be effective, the different release profiles of each formulation can result in distinct differences between the effects on measures of attention and deportment. 
  275. ^ Coghill, David; Banaschewski, Tobias; Zuddas, Alessandro; Pelaz, Antonio; Gagliano, Antonella; Doepfner, Manfred. Erratum to: Long-acting methylphenidate formulations in the treatment of attention-deficit/hyperactivity disorder: a systematic review of head-to-head studies. BMC Psychiatry (Springer Nature). 2015-08-25, 15 (1). ISSN 1471-244X. PMC 4549088. PMID 26302778. doi:10.1186/s12888-015-0581-z. 
  276. ^ Coghill, David; Banaschewski, Tobias; Zuddas, Alessandro; Pelaz, Antonio; Gagliano, Antonella; Doepfner, Manfred. Long-acting methylphenidate formulations in the treatment of attention-deficit/hyperactivity disorder: a systematic review of head-to-head studies. BMC Psychiatry (Springer Nature). 2013-09-27, 13 (1). ISSN 1471-244X. PMC 3852277. PMID 24074240. doi:10.1186/1471-244x-13-237. 
  277. ^ Coghill, David; Banaschewski, Tobias; Zuddas, Alessandro; Pelaz, Antonio; Gagliano, Antonella; Doepfner, Manfred. Long-acting methylphenidate formulations in the treatment of attention-deficit/hyperactivity disorder: a systematic review of head-to-head studies. BMC Psychiatry (Springer Nature). 2013-09-27, 13 (1). ISSN 1471-244X. doi:10.1186/1471-244x-13-237. 
  278. ^ Biphentin Product Monograph. (PDF). Purdue Pharma. 2017-04-12. (原始内容存档 (PDF)于2018-07-14). 
  279. ^ Adjei, Akwete; Teuscher, Nathan S.; Kupper, Robert J.; Chang, Wei-Wei; Greenhill, Laurence; Newcorn, Jeffrey H.; Connor, Daniel F.; Wigal, Sharon. Single-Dose Pharmacokinetics of Methylphenidate Extended-Release Multiple Layer Beads Administered as Intact Capsule or Sprinkles Versus Methylphenidate Immediate-Release Tablets (Ritalin®) in Healthy Adult Volunteers. Journal of child and adolescent psychopharmacology (Mary Ann Liebert Inc). 2014, 24 (10): 570–578. ISSN 1044-5463. PMC 4268571. PMID 25514542. doi:10.1089/cap.2013.0135. 
  280. ^ Concerta Product Monograph. (PDF). Janssen Inc. 2017-11-27. (原始内容存档 (PDF)于2018-04-22). 
  281. ^ Ritalin Summary of Product Characteristics.. Novartis Pharmaceuticals UK Ltd. 26 Apr 2018. (原始内容存档于2018-07-14). 
  282. ^ Medikinet Summary of Product Characteristics.. Flynn Pharma Ltd. 20 March 2017. (原始内容存档于2018年7月14日). 
  283. ^ Wang, Yanfeng; Lee, Lucy; Somma, Russell; Thompson, Glenn; Bakhtiar, Ray; Lee, James; Rekhi, Gurvinder Singh; Lau, Henry; Sedek, Greg; Hossain, Mohammad. In vitro dissolution andin vivo oral absorption of methylphenidate from a bimodal release formulation in healthy volunteers. Biopharmaceutics & drug disposition (Wiley). 2004-02-05, 25 (2): 91–98. ISSN 0142-2782. PMID 14872557. doi:10.1002/bdd.390. 
  284. ^ Dexedrine Product Monograph. (PDF). Paladin Labs Inc. Last updated 21 March 2016. (原始内容存档 (PDF)于2016年4月18日). 
  285. ^ Wong, YN; Wang, L; Hartman, L; Simcoe, D; Chen, Y; Laughton, W; Eldon, R; Markland, C; Grebow, P, Comparison of the single-dose pharmacokinetics and tolerability of modafinil and dextroamphetamine administered alone or in combination in healthy male volunteers., Journal of clinical pharmacology, 1998, 38 (10): 971–8, ISSN 0091-2700, PMID 9807980 
  286. ^ Elvanse 20mg Capsules, hard - Summary of Product Characteristics (SmPC). (eMC). 2018-04-03 [2018-07-18]. (原始内容存档于2018-07-18).  |accessdate=|access-date=只需其一 (帮助)
  287. ^ Elvanse Adult 30mg Capsules, hard - Summary of Product Characteristics (SmPC). (eMC). 2017-11-03 [2018-07-18]. (原始内容存档于2018-07-18).  |accessdate=|access-date=只需其一 (帮助)
  288. ^ Krishnan, Suma; Zhang, Yuxin. Relative Bioavailability of Lisdexamfetamine 70-mg Capsules in Fasted and Fed Healthy Adult Volunteers and in Solution: A Single-Dose, Crossover Pharmacokinetic Study. Journal of clinical pharmacology (Wiley). 2008, 48 (3): 293–302. ISSN 0091-2700. PMID 18285619. doi:10.1177/0091270007310381. 
  289. ^ Adderall XR Canadian Product Monograph. (PDF). shirecanada.com. Last updated 23 September 2015. 
  290. ^ Witcher JW, Long A, Smith B, et al. Atomoxetine pharmacokinetics in children and adolescents with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 2003; 13: 53-63.
  291. ^ Intuniv Summary of Product Characteristics. Last updated 10 December 2015.
  292. ^ Swearingen D, Pennick M, Shojaei A, et al. A phase I, randomized, open-label, crossover study of the single-dose pharmacokinetic properties of guanfacine extended-release 1-, 2-, and 4-mg tablets in healthy adults. Clin Ther 2007; 29: 617-625.
  293. ^ Amfexa Summary of Product Characteristics. Flynn Pharma Ltd. Last updated 06 June 2016.
  294. ^ Dexamfetamine Sulphate Summary of Product Characteristics. Auden Mckenzie (Pharma Division) Ltd. Last updated 01 August 2016.
  295. ^ Matoride XL Summary of Product Characteristics. Sandoz Ltd. Last updated 02 December 2015.
  296. ^ Haffey MB, Buckwalter M, Zhang P, et al. Effects of omeprazole on the pharmacokinetic profiles of lisdexamfetamine dimesylate and extended-release mixed amphetamine salts in adults. Postgrad Med 2009; 121: 11-19.
  297. ^ Gonzalez MA, Pentikis HS, Anderl N, et al. Methylphenidate bioavailability from two extended-release formulations. Int J Clin Pharmacol Ther 2002; 40: 175-184.
  298. ^ Equasym XL Summary of Product Characteristics. Shire Pharmaceuticals Ltd. Last updated 10 March 2014.
  299. ^ Medikinet XL Summary of Product Characteristics. Flynn Pharma Ltd. Last updated 17 June 2014.
  300. ^ Haessler F, Tracik F, Dietrich H, et al. A pharmacokinetic study of two modified-release methylphenidate formulations under different food conditions in healthy volunteers. Int J Clin Pharmacol Ther 2008; 46: 466-476.
  301. ^ Ritalin LA Summary of Product Characteristics. Novartis Pharmaceuticals Corporation. Last updated 29 June 2015.
  302. ^ 302.0 302.1 Heal, DJ; Pierce, DM. Methylphenidate and its isomers: their role in the treatment of attention-deficit hyperactivity disorder using a transdermal delivery system.. CNS drugs. 2006, 20 (9): 713–38. ISSN 1172-7047. PMID 16953648. 
  303. ^ Wolraich, ML; Doffing, MA. Pharmacokinetic considerations in the treatment of attention-deficit hyperactivity disorder with methylphenidate.. CNS drugs. 2004, 18 (4): 243–50. ISSN 1172-7047. PMID 15015904. 
  304. ^ Strattera Summary of Product Characteristics. Eli Lilly and Company Ltd. Last updated 08 June 2015.
  305. ^ Focalin XR US Prescribing Information. Novartis Pharmaceuticals Corporation. Last updated June 2015.
  306. ^ Tuerck D, Wang Y, Maboudian M, et al. Similar bioavailability of dexmethylphenidate extended (bimodal) release, dexmethyl-phenidate immediate release and racemic methylphenidate extended (bimodal) release formulations in man. Int J Clin Pharmacol Ther 2007; 45: 662-668.
  307. ^ Pharmacokinetic data for the ADHD treatments: methylphenidate, dexamfetamine, lisdexamfetamine sulphate, mixed amfetamine salts, atomoxetine and guanfacine, ADHD Instituite, January 2017 
  308. ^ Coghill, David; Banaschewski, Tobias; Zuddas, Alessandro; Pelaz, Antonio; Gagliano, Antonella; Doepfner, Manfred. Long-acting methylphenidate formulations in the treatment of attention-deficit/hyperactivity disorder: a systematic review of head-to-head studies. BMC psychiatry (Springer Nature). 2013-09-27, 13 (1). ISSN 1471-244X. PMC 3852277. PMID 24074240. doi:10.1186/1471-244x-13-237. 
  309. ^ JS, Markowitz; Al., Et. Pharmacokinetics of methylphenidate after oral administration of two modified-release formulations in healthy adults. - PubMed. NCBI. 2018-09-27 [2018-09-27]. (原始内容存档于2018-09-27). 
  310. ^ 310.0 310.1 Huss, Michael; Duhan, Praveen; Gandhi, Preetam; Chen, Chien-Wei; Spannhuth, Carsten; Kumar, Vinod. Methylphenidate dose optimization for ADHD treatment: review of safety, efficacy, and clinical necessity. Neuropsychiatric Disease and Treatment (Systematic review (Secondary source)) (Dove Medical Press Ltd.). 2017-07-04,. Volume 13: 1741–1751. ISSN 1178-2021. PMC 5505611. PMID 28740389. doi:10.2147/ndt.s130444. Fredriksen et al conducted a naturalistic study to assess the 1-year efficacy of ADHD treatment regimens in adults with ADHD.59 All patients received MPH as the first-line pharmacological treatment in addition to psychosocial interventions. The study was conducted at a specialized outpatient clinic in Norway and involved a 6-week MPH titration phase (up to 60 mg/day) followed by a dose-optimization phase (maximum dose 120 mg/day). 
  311. ^ 311.0 311.1 Sikirica, Vanja; Lu, Mei; Greven, Peter; Zhong, Yichen; Qin, Paige; Xie, Jipan; Gajria, Kavita. Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review. Neuropsychiatric Disease and Treatment (Dove Medical Press Ltd.). 2014-08-22, 10: 1543. ISSN 1178-2021. PMC 4149449. PMID 25187718. doi:10.2147/ndt.s65721. 
  312. ^ 312.0 312.1 Fredriksen, Mats; Dahl, Alv A.; Martinsen, Egil W.; Klungsøyr, Ole; Haavik, Jan; Peleikis, Dawn E. Effectiveness of one-year pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD): An open-label prospective study of time in treatment, dose, side-effects and comorbidity. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology (Elsevier BV). 2014, 24 (12): 1873–1884. ISSN 0924-977X. PMID 25453480. doi:10.1016/j.euroneuro.2014.09.013. 
  313. ^ 313.0 313.1 Esposito, Gianluca; Azhari, Atiqah; Borelli, Jessica L. Gene × Environment Interaction in Developmental Disorders: Where Do We Stand and What’s Next?. Frontiers in psychology (Frontiers Media SA). 2018-10-26, 9. ISSN 1664-1078. PMC 6212589. PMID 30416467. doi:10.3389/fpsyg.2018.02036. 
  314. ^ 江雅暄. 過動兒與藥物治療. 台大醫院. [2018-04-06]. (原始内容存档于2017-03-13). 
  315. ^ Newcorn, Jeffrey H; Ivanov, Iliyan. Psychopharmacologic Treatment of Attention-Deficit/Hyperactivity Disorder and Disruptive Behavior Disorders. Pediatric Annals 2007. 2007-09-01, 36 (9): 564-574. doi:10.3928/0090-4481-20070901-08. (原始内容存档于2018-04-06). The labeled daily maximum dose of d,l-MPH is 60 mg, with the exception of OROS-MPH, which is approved for 54 mg in children and 72 mg in adolescents 
  316. ^ 316.0 316.1 Wolraich, M; Brown, L; Brown, RT; DuPaul, G; Earls, M; Feldman, HM; Ganiats, TG; Kaplanek, B; Meyer, B; Perrin, J; Pierce, K; Reiff, M; Stein, MT; Visser, S. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents.. Pediatrics. 2011, 128 (5): 1007–22. ISSN 0031-4005. PMC 4500647701937 请检查|pmc=值 (帮助). PMID 22003063. doi:10.1542/peds.2011-2654. 
  317. ^ Neinstein, Lawrence. Handbook of adolescent health care. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2009. ISBN 978-0-7817-9020-8. OCLC 226304727. 
  318. ^ CONCERTA® - Contact Us. Janssen Cilag. [2017-01]. (原始内容存档于2017-10-06). 
  319. ^ THE PROHIBITED LIST Updated annually, the List identifies the substances and methods prohibited to athletes in- and out-of-competition (PDF). Wada-main-prod.s3.amazonaws.com. [2016-12-27]. (原始内容存档 (PDF)于2016-12-20). 
  320. ^ 320.0 320.1 Home of MedlinePlus→ Health Topics → Attention Deficit Hyperactivity Disorder Attention Deficit Hyperactivity Disorder Also called: ADHD. Medlineplus.gov. [2016-12-27]. (原始内容存档于2016-12-25). 
  321. ^ 衛生福利部-食品藥物管理署-管制藥品. Fda.gov.tw. 2013-12-30 [2016-12-27]. (原始内容存档于2017-01-20). 
  322. ^ 衛生福利部-食品藥物管理署-管制藥品的管理. Fda.gov.tw. [2016-12-27]. (原始内容存档于2016-12-26). 
  323. ^ 323.0 323.1 323.2 323.3 323.4 FDA Drug Safety Communication: Safety Review Update of Medications used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) in children and young adults. U S Food and Drug Administration Home Page. 2011-11-01 [2018-09-30]. (原始内容存档于2018-07-26). 
  324. ^ Pharmacotherapy for adult attention deficit hyperactivity disorder. UpToDate. [2018-02-27]. (原始内容存档于2018-02-27). Cardiovascular effects — Blood pressure and heart rate should be monitored when initiating stimulants for adult ADHD and over the course of treatment, due to stimulants' potential for causing cardiovascular side effects....... 
  325. ^ 325.0 325.1 Wender, PH. Pharmacotherapy of attention-deficit/hyperactivity disorder in adults.. The Journal of clinical psychiatry. 1998,. 59 Suppl 7: 76–9. ISSN 0160-6689. PMID 9680056. 
  326. ^ Wilens, TE; Hammerness, PG; Biederman, J; Kwon, A; Spencer, TJ; Clark, S; Scott, M; Podolski, A; Ditterline, JW; Morris, MC; Moore, H, Blood pressure changes associated with medication treatment of adults with attention-deficit/hyperactivity disorder., The Journal of clinical psychiatry, 2005, 66 (2): 253–9, ISSN 0160-6689, PMID 15705013 
  327. ^ Hypoglycemia: MedlinePlus. MedlinePlus. 2017-11-07 [2017-12-23]. (原始内容存档于2017-12-22). You can also have low blood sugar without having diabetes. Causes include certain medicines or diseases, hormone or enzyme deficiencies, and tumors. Laboratory tests can help find the cause. The kind of treatment depends on why you have low blood sugar. 
  328. ^ Low Blood Glucose (Hypoglycemia). National Institute of Diabetes and Digestive and Kidney Diseases. 2016-08-11 [2017-12-23]. (原始内容存档于2017-07-28). Fast or irregular heart beat 
  329. ^ Peptic ulcer disease: Genetic, environmental, and psychological risk factors and pathogenesis. UpToDate. [2018-07-15]. (原始内容存档于2018-07-15). 
  330. ^ The Safety of Stimulant Medication Use in Cardiovascular and Arrhythmia Patients. American College of Cardiology (tertiary source). 2015-04-28 [2017-12-08]. (原始内容存档于2017-12-09). 
  331. ^ Biederman, Joseph; Mick, Eric; Surman, Craig; Doyle, Robert; Hammerness, Paul; Harpold, Theresa; Dunkel, Stephanie; Dougherty, Meghan; Aleardi, Megan; Spencer, Thomas. A Randomized, Placebo-Controlled Trial of OROS Methylphenidate in Adults with Attention-Deficit/Hyperactivity Disorder. Biological psychiatry (Elsevier BV). 2006-05-01, 59 (9): 829–835. ISSN 0006-3223. PMID 16373066. doi:10.1016/j.biopsych.2005.09.011. 
  332. ^ Hammerness, Paul; Wilens, Timothy; Mick, Eric; Spencer, Thomas; Doyle, Robert; McCreary, Michelle; Becker, Judith; Biederman, Joseph. Cardiovascular Effects of Longer-Term, High-Dose OROS Methylphenidate in Adolescents with Attention Deficit Hyperactivity Disorder. The Journal of pediatrics (Elsevier BV). 2009, 155 (1): 84–89.e1. ISSN 0022-3476. PMID 19394037. doi:10.1016/j.jpeds.2009.02.008. 
  333. ^ Adler, Lenard A.; Orman, Camille; Starr, H. Lynn; Silber, Steve; Palumbo, Joseph; Cooper, Kimberly; Berwaerts, Joris; Harrison, Diane D. Long-Term Safety of OROS Methylphenidate in Adults With Attention-Deficit/Hyperactivity Disorder. Journal of clinical psychopharmacology (Ovid Technologies (Wolters Kluwer Health)). 2011, 31 (1): 108–114. ISSN 0271-0749. PMID 21192153. doi:10.1097/jcp.0b013e318203ea0a. 
  334. ^ Weisler, RH; Biederman, J; Spencer, TJ; Wilens, TE. Long-term cardiovascular effects of mixed amphetamine salts extended release in adults with ADHD.. CNS spectrums. 2005, 10 (12 Suppl 20): 35–43. ISSN 1092-8529. PMID 16344839. 
  335. ^ Simpson, Dene; Plosker, Greg L. Atomoxetine: a review of its use in adults with attention deficit hyperactivity disorder.. Drugs (Springer Nature). 2004, 64 (2): 205–222. ISSN 0012-6667. PMID 14717619. doi:10.2165/00003495-200464020-00005. 
  336. ^ Wernicke, Joachim F; Faries, Douglas; Girod, Donald; Brown, Jeffrey W; Gao, Haitao; Kelsey, Douglas; Quintana, Humberto; Lipetz, Robert; Michelson, David; Heiligenstein, John. Cardiovascular Effects of Atomoxetine in Children, Adolescents, and Adults. Drug safety (Springer Nature). 2003, 26 (10): 729–740. ISSN 0114-5916. PMID 12862507. doi:10.2165/00002018-200326100-00006. 
  337. ^ Adler, Lenard A.; Spencer, Thomas J.; Williams, David W.; Moore, Rodney J.; Michelson, David. Long-Term, Open-Label Safety and Efficacy of Atomoxetine in Adults With ADHD. Journal of attention disorders (SAGE Publications). 2008-04-30, 12 (3): 248–253. ISSN 1087-0547. PMID 18448861. doi:10.1177/1087054708316250. 
  338. ^ Habel, Laurel A.; Cooper, William O.; Sox, Colin M.; Chan, K. Arnold; Fireman, Bruce H.; Arbogast, Patrick G.; Cheetham, T. Craig; Quinn, Virginia P.; Dublin, Sascha; Boudreau, Denise M.; Andrade, Susan E.; Pawloski, Pamala A.; Raebel, Marsha A.; Smith, David H.; Achacoso, Ninah; Uratsu, Connie; Go, Alan S.; Sidney, Steve; Nguyen-Huynh, Mai N.; Ray, Wayne A.; Selby, Joe V. ADHD Medications and Risk of Serious Cardiovascular Events in Young and Middle-aged Adults. JAMA (American Medical Association (AMA)). 2011-12-28, 306 (24): 2673. ISSN 0098-7484. PMC 3350308370952 请检查|pmc=值 (帮助). PMID 22161946. doi:10.1001/jama.2011.1830. 
  339. ^ 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). Evaluation of children with ADHD prior to initiation of medication should include a comprehensive, cardiovascular (CV)-focused patient history, family history, and physical examination 
  340. ^ 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). One small study suggested that there may be evidence of arterial stiffness, but further investigation is needed to confirm and determine any clinically significant effect 
  341. ^ Kelly, Aaron S.; Rudser, Kyle D.; Dengel, Donald R.; Kaufman, Christopher L.; Reiff, Michael I.; Norris, Anne L.; Metzig, Andrea M.; Steinberger, Julia. Cardiac Autonomic Dysfunction and Arterial Stiffness among Children and Adolescents with Attention Deficit Hyperactivity Disorder Treated with Stimulants. The Journal of pediatrics (Elsevier BV). 2014, 165 (4): 755–759. ISSN 0022-3476. PMID 25015574. doi:10.1016/j.jpeds.2014.05.043. 
  342. ^ How High Blood Pressure Damages Arteries. MyHealth.Alberta.ca. 2019-01-04 [2019-01-04]. 
  343. ^ Rekha Mankad, M.D. Coronary artery spasm: Cause for concern?. Mayo Clinic. 2018-10-13 [2019-01-04]. 
  344. ^ High blood pressure dangers: Hypertension's effects on your body. Mayo Clinic. 2016-11-23 [2019-01-04]. 
  345. ^ Hubel, R.; Jass, J.; Marcus, A.; Laessle, R. G. Overweight and basal metabolic rate in boys with attention-deficit/hyperactivity disorder. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity (Springer Nature). 2006, 11 (3): 139–146. ISSN 1124-4909. doi:10.1007/bf03327559. 
  346. ^ Increasing Metabolism. WW (Weight Watchers Reimagined). 2018-11-27 [2018-11-27]. (原始内容存档于2018-11-27). A person's heart rate has an impact on metabolism – the higher the heart rate, the more calories burned. Stimulants, whether from a prescribed medication, dietary supplement, or a caffeine-containing beverage, all work to increase the heart rate and fire up the nervous system. 
  347. ^ Acheson, K J; Zahorska-Markiewicz, B; Pittet, P; Anantharaman, K; Jéquier, E. Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals. The American Journal of Clinical Nutrition. 1980-05-01, 33 (5): 989–997 [2018-11-27]. ISSN 0002-9165. doi:10.1093/ajcn/33.5.989. (原始内容存档于2018-11-13). 
  348. ^ ISAAC STARR, C. J. GAMBLE, A. MARGOLIES, J. S.,DONAL, JR., N. JOSEPH AND E. EAGLE. A CLINICAL STUDY OF THE ACTION OF 10 COMMONLY USED DRUGS ON CARDIAC OUTPUT, WORK AND SIZE; ON RESPIRATION, ON METABOLIC RATE AND ON THE ELECTROCARDIOGRAM. Am Soc Clin Investig (Departments of Research Therapeutics, and of Pharmacology, the Robinette Foundation, and the Medical Division of the Hospital of the University of Pennsylvania., Philadelphia). 1937. 
  349. ^ Pharmacotherapy-for-Adult-Attention-Deficit-Hyperactivity-Disorder. UpToDate. [2018-02-26]. (原始内容存档于2018-02-27). 
  350. ^ Santosh, Paramala J.; Sattar, Sanjida; Canagaratnam, Myooran. Efficacy and Tolerability of Pharmacotherapies for Attention-Deficit Hyperactivity Disorder in Adults. CNS drugs (Springer Nature). 2011-09-01, 25 (9): 737–763. ISSN 1172-7047. PMID 21870887. doi:10.2165/11593070-000000000-00000. 
  351. ^ Pharmacotherapy-for-Adult-Attention-Deficit-Hyperactivity-Disorder. UpToDate. [2018-02-26]. (原始内容存档于2018-02-27). An uncontrolled follow-up of 96 adults with ADHD who experienced improvement while taking extended release methylphenidate in a randomized trial found that improvement in ADHD symptoms was sustained at 30 weeks on the medication. Only 39 subjects (40.6 percent) completed the long-term follow-up period. Participants continued to experience decreased appetite, insomnia, and jitteriness 
  352. ^ Biederman, Joseph; Mick, Eric; Surman, Craig; Doyle, Robert; Hammerness, Paul; Kotarski, Meghan; Spencer, Thomas. A Randomized, 3-Phase, 34-Week, Double-Blind, Long-Term Efficacy Study of Osmotic-Release Oral System-Methylphenidate in Adults With Attention-Deficit/Hyperactivity Disorder. Journal of clinical psychopharmacology (Ovid Technologies (Wolters Kluwer Health)). 2010, 30 (5): 549–553. ISSN 0271-0749. PMID 20814332. doi:10.1097/jcp.0b013e3181ee84a7. 
  353. ^ 353.0 353.1 Adderall XR Prescribing Information (PDF). United States Food and Drug Administration. Shire US Inc: 11. 2013-12 [2013-12-30]. (原始内容存档 (PDF)于2013-12-30). 
  354. ^ 354.0 354.1 Adderall XR Prescribing Information (PDF). United States Food and Drug Administration. Shire US Inc: 4–8. 2013-12 [2013-12-30]. (原始内容存档 (PDF)于2013-12-30). 
  355. ^ Shoptaw, SJ; Kao, U; Ling, W. Treatment for amphetamine psychosis.. The Cochrane database of systematic reviews. 2009-01-21, (1): CD003026. ISSN 1469-493X. PMID 19160215. doi:10.1002/14651858.CD003026.pub3. A minority of individuals who use amphetamines develop full-blown psychosis requiring care at emergency departments or psychiatric hospitals. In such cases, symptoms of amphetamine psychosis commonly include paranoid and persecutory delusions as well as auditory and visual hallucinations in the presence of extreme agitation. More common (about 18%) is for frequent amphetamine users to report psychotic symptoms that are sub-clinical and that do not require high-intensity intervention ... About 5–15% of the users who develop an amphetamine psychosis fail to recover completely (Hofmann 1983) ... Findings from one trial indicate use of antipsychotic medications effectively resolves symptoms of acute amphetamine psychosis.  参数|quote=值左起第492位存在換行符 (帮助)
  356. ^ Greydanus D. Stimulant Misuse: Strategies to Manage a Growing Problem (PDF). American College Health Association (Review Article). ACHA Professional Development Program: 20. [2013-11-02]. (原始内容 (PDF)存档于2013-11-03). 
  357. ^ Nigg, JT. Attention-deficit/hyperactivity disorder and adverse health outcomes. Clinical psychology review (Elsevier BV). 2013, 33 (2): 215–228. ISSN 0272-7358. PMC 4322430. PMID 23298633. doi:10.1016/j.cpr.2012.11.005. 
  358. ^ 陳錦宏. 心動家族協會理事長專文:問ADHD藥物有無風險,不如問「不治療和治療的風險哪一個高」. 心動家族協會. 2016-04-18 [2017-01]. (原始内容存档于2017-01-03).  |archiveurl=|archive-url=只需其一 (帮助); |accessdate=|access-date=只需其一 (帮助); |archivedate=|archive-date=只需其一 (帮助)
  359. ^ 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. 
  360. ^ Choices, N. H. S. What is a controlled medicine (drug)? - Health questions - NHS Choices. 2016-12-12. (原始内容存档于2017-05-03). 
  361. ^ Methylphenidate. Home of MedlinePlus → Drugs, Herbs and Supplements → Methylphenidate Methylphenidate pronounced as (meth il fen' i date). 2016-02-15 [2017-02-27]. (原始内容存档于2017-07-04). 
  362. ^ 362.0 362.1 362.2 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). "Three studies to be published in the August 2016 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) 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.", August, 2016  |archiveurl=|archive-url=只需其一 (帮助); |accessdate=|access-date=只需其一 (帮助); |archivedate=|archive-date=只需其一 (帮助)
  363. ^ Adults with ADHD. MedlinePlus the Magazine 9. 8600 Rockville Pike • Bethesda, MD 20894, United States of America: NATIONAL LIBRARY OF MEDICINE at the NATIONAL INSTITUTES OF HEALTH. 2014: 19. ISSN 1937-4712. (原始内容存档于2017-07-15) (美国英语). 
  364. ^ Attention deficit hyperactivity disorder. Home → Medical Encyclopedia → Attention deficit hyperactivity disorder. NATIONAL LIBRARY OF MEDICINE at the NATIONAL INSTITUTES OF HEALTH. 2016-05-25 [2017-02-27]. (原始内容存档于2017-01-26). 
  365. ^ All Disorders. National Institute of Neurological Disorders and Stroke. [February twenty seventh, 2017]. (原始内容存档于2016-12-02). 
  366. ^ 366.0 366.1 Overview of palpitations in adults. UpToDate. [2018-07-15]. (原始内容存档于2018-07-16).  |accessdate=|access-date=只需其一 (帮助)
  367. ^ 367.0 367.1 Approach to the child with palpitations. UpToDate. [2018-07-15]. (原始内容存档于2018-07-16).  |accessdate=|access-date=只需其一 (帮助)
  368. ^ 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=|access-date=只需其一 (帮助)
  369. ^ Pharmacotherapy-for-Adult-Attention-Deficit-Hyperactivity-Disorder. UpToDate. [2018-02-26]. (原始内容存档于2018-02-27). Progressive titration, as tolerated, to an optimally effective dose is an important means of minimizing side effects. Re-titration may be necessary after drug holidays. 
  370. ^ Castells, Xavier; Cunill, Ruth; Capellà, Dolors. Treatment discontinuation with methylphenidate in adults with attention deficit hyperactivity disorder: a meta-analysis of randomized clinical trials. European journal of clinical pharmacology (Springer Nature). 2012-09-16, 69 (3): 347–356. ISSN 0031-6970. PMID 22983311. doi:10.1007/s00228-012-1390-7. 
  371. ^ Anderson, Kayla N.; Ailes, Elizabeth C.; Danielson, Melissa; Lind, Jennifer N.; Farr, Sherry L.; Broussard, Cheryl S.; Tinker, Sarah C. Attention-Deficit/Hyperactivity Disorder Medication Prescription Claims Among Privately Insured Women Aged 15–44 Years — United States, 2003–2015. MMWR. Morbidity and mortality weekly report (Centers for Disease Control MMWR Office). 2018-01-19, 67 (2): 66–70. ISSN 0149-2195. PMC 5772805. PMID 29346342. doi:10.15585/mmwr.mm6702a3. 
  372. ^ Auiler, J. F.; Liu, K.; Lynch, J. M.; Gelotte, C. K. Effect of Food on Early Drug Exposure from Extended-Release Stimulants: Results from the Concerta®, Adderall XR™ Food Evaluation (CAFÉ) Study. Current medical research and opinion (Informa Healthcare). 2002, 18 (5): 311–316. ISSN 0300-7995. PMID 12240794. doi:10.1185/030079902125000840. The food effect on early drug exposure and the pharmacokinetic profiles up to 8 h after dosing of the two extended-release stimulants were directly compared using partial area (AUC(p4h), AUC(p6h) and AUC(p8h)) fed/fasted ratios. Amphetamine concentrations were markedly lower when the subjects had eaten breakfast, resulting in lower early drug exposures (p < 0.0001). By contrast, methylphenidate concentrations over the same 8 h were unaffected by breakfast, providing consistent levels of early drug exposure. Therefore, as a child's or adult's eating pattern varies, methylphenidate exposure over the first 8 h would be expected to have less day-to-day variation compared with amphetamine exposure. The osmotic-controlled OROS tablet provides a reliable and consistent delivery of methylphenidate HCI, independent of food, for patients with ADHD. 
  373. ^ Malenka RC, Nestler EJ, Hyman SE. Chapters 10 and 13. (编) Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience 2nd. New York: McGraw-Hill Medical. 2009: 266, 318–323. ISBN 978-0-07-148127-4. 
  374. ^ Malenka RC, Nestler EJ, Hyman SE. Chapter 6: Widely Projecting Systems: Monoamines, Acetylcholine, and Orexin. (编) Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience 2nd. New York: McGraw-Hill Medical. 2009: 148, 154–157. ISBN 978-0-07-148127-4. 
  375. ^ Weiss MD, Gadow K, Wasdell MB. Effectiveness outcomes in attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2006,. 67 Suppl 8: 38–45. PMID 16961429. 
  376. ^ Ruiz-Goikoetxea, Maite; Cortese, Samuele; Aznarez-Sanado, Maite; Magallón, Sara; Alvarez Zallo, Noelia; Luis, Elkin O.; de Castro-Manglano, Pilar; Soutullo, Cesar; Arrondo, Gonzalo. Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews. 2018, 84: 63–71. ISSN 0149-7634. PMID 29162520. doi:10.1016/j.neubiorev.2017.11.007. 
  377. ^ Dalsgaard, Søren; Leckman, James F.; Mortensen, Preben Bo; Nielsen, Helena Skyt; Simonsen, Marianne. Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: a prospective cohort study. The Lancet. Psychiatry. 1 August 2015, 2 (8): 702–709. ISSN 2215-0374. PMID 26249301. doi:10.1016/S2215-0366(15)00271-0. 
  378. ^ 378.0 378.1 Arnold LE. Methylphenidate vs Amphetamine: Comparative Review. Journal of Attention Disorders. 2000, 3 (4): 200–211. doi:10.1177/108705470000300403.  已忽略未知参数|doi-access= (帮助)
  379. ^ Rapoport JL, Inoff-Germain G. Responses to methylphenidate in Attention-Deficit/Hyperactivity Disorder and normal children: update 2002. J Atten Disord. 2002,. 6 Suppl 1: S57–60. PMID 12685519. 
  380. ^ Dusan Kolar; Amanda Keller; Maria Golfinopoulos; Lucy Cumyn; Cassidy Syer; Lily Hechtman. Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat. February 2008, 4 (1): 107–121. PMC 2515906. PMID 18728812. doi:10.2147/ndt.s1747. 
  381. ^ Spencer TJ. Pharmacology of adult ADHD with stimulants. CNS Spectr. April 2007, 12 (4(supplement 6)): 8–11. PMID 17715564. doi:10.1017/S1092852900026018. 
  382. ^ Rostain, Anthony L. ADHD in Adults: Attention-Deficit/Hyperactivity Disorder in Adults: Evidence-Based Recommendations for Management. Postgraduate Medicine. September 2008, 120 (3): 27–38. PMID 18824823. doi:10.3810/pgm.2008.09.1905. 
  383. ^ Spencer, Thomas; Biederman, Joseph; Wilens, Timothy. Stimulant treatment of adult attention-deficit/hyperactivity disorder. Psychiatric Clinics of North America. June 2004, 27 (2): 361–372. PMID 15064002. doi:10.1016/j.psc.2003.12.002. 
  384. ^ Higgins ES. A comparative analysis of antidepressants and stimulants for the treatment of adults with attention-deficit hyperactivity disorder. J Fam Pract. January 1999, 48 (1): 15–20. PMID 9934377. 
  385. ^ Verbeeck W, Tuinier S, Bekkering GE. Antidepressants in the treatment of adult attention-deficit hyperactivity disorder: a systematic review. Adv Ther. February 2009, 26 (2): 170–184. PMID 19238340. doi:10.1007/s12325-009-0008-7. 
  386. ^ Findling, RL; Dinh, S. Transdermal therapy for attention-deficit hyperactivity disorder with the methylphenidate patch (MTS).. CNS drugs. 2014, 28 (3): 217–28. ISSN 1172-7047. PMC 3933749. PMID 24532028. doi:10.1007/s40263-014-0141-y. 
  387. ^ 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.
     
  388. ^ 388.0 388.1 Label of Concerta. DailyMed.gov. Jassen Cilag. 2013 [January, 2017.]. (原始内容存档于2017-03-26). 
  389. ^ Label of Concerta. DailyMed.gov. Jassen Cilag. 2013 [January, 2017.]. (原始内容存档于2017-03-26). 
  390. ^ Childress, A. C.; Sallee, F. R. Revisiting clonidine: an innovative add-on option for attention-deficit/hyperactivity disorder. Drugs of Today (Barcelona, Spain: 1998). 2012, 48 (3): 207–217. ISSN 1699-3993. PMID 22462040. doi:10.1358/dot.2012.48.3.1750904. There are a number of non-stimulant medications, such as atomoxetine, bupropion, guanfacine, and clonidine that may be used as alternatives, or added to stimulant therapy. 
  391. ^ 391.0 391.1 McDonagh MS, Peterson K, Thakurta S, Low A. Drug Class Review: Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder. Drug Class Reviews. United States Library of Medicine. December 2011. PMID 22420008. (原始内容存档于31 August 2016).  已忽略未知参数|df= (帮助)
  392. ^ Prasad V, Brogan E, Mulvaney C, Grainge M, Stanton W, Sayal K. How effective are drug treatments for children with ADHD at improving on-task behaviour and academic achievement in the school classroom? A systematic review and meta-analysis. European Child & Adolescent Psychiatry. April 2013, 22 (4): 203–16. PMID 23179416. doi:10.1007/s00787-012-0346-x. 
  393. ^ Hazell P. The challenges to demonstrating long-term effects of psychostimulant treatment for attention-deficit/hyperactivity disorder. Current Opinion in Psychiatry. July 2011, 24 (4): 286–90. PMID 21519262. doi:10.1097/YCO.0b013e32834742db. 
  394. ^ 394.0 394.1 394.2 394.3 394.4 394.5 394.6 394.7 DailyMed - STRATTERA- atomoxetine hydrochloride capsule STRATTERA- atomoxetine hydrochloride. DailyMed.com. Eli Lilly. 2015-06. (原始内容存档于2017-09-02). 
  395. ^ 395.0 395.1 Label of Strattera consisting of atomoxetine. DailyMed.gov. Eli Lilly Company. 2015-06 [2017-02]. DOSAGE AND ADMINISTRATION 2.1 Acute Treatment Dosing of children and adolescents up to 70 kg body weight......No additional benefit has been demonstrated for doses higher than 1.2 mg/kg/day [see Clinical Studies (14)]. 'The total daily dose in children and adolescents should not exceed 1.4 mg/kg or 100 mg, whichever is less'. Dosing of children and adolescents over 70 kg body weight and adults......The maximum recommended total daily dose in children and adolescents over 70 kg and adults is 100 mg. 
  396. ^ Atomoxetine: Drug information. UpToDate. 2017-12-28 [2017-12-28]. (原始内容存档于2017-12-28). Duration of action: Up to 24 hours (Jain 2017) 
  397. ^ Taylor, D; Paton, C; Shitij, K. The Maudsley prescribing guidelines in psychiatry. West Sussex: Wiley-Blackwell. 2012. ISBN 978-0-470-97948-8. 
  398. ^ Kooij, JJS. Adult ADHD Diagnostic Assessment and Treatment (PDF). Springer London. 2013. ISBN 978-1-4471-4137-2. doi:10.1007/978-1-4471-4138-9. 
  399. ^ How long for Strattera to start working? (PDF). Minnesota National Allianceof Mental Illness. [2017-02]. (原始内容 (PDF)存档于2015-12-24). It may take 4 - 8 weeks after an effective dose is reached for atomoxetine to reach maximum effectiveness. However, improvements in some symptoms may occur sooner. 
  400. ^ 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. 
  401. ^ Atomoxetine in adults with ADHD: two randomized, placebo-controlled studies. Biological Psychiatry. 2003-01-15, 53 (2): 112–120 [2017-12-28]. ISSN 0006-3223. doi:10.1016/S0006-3223(02)01671-2. 
  402. ^ 402.0 402.1 atomoxetine (Rx) – Strattera. Medscape Reference. WebMD. [2013-11-10]. (原始内容存档于2013-11-10). 
  403. ^ 403.0 403.1 Drug information for atomoxetine. UpToDate. [2018-02-26]. (原始内容存档于2017-12-28). 
  404. ^ 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. 
  405. ^ 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」
  406. ^ Myriam Harfterkamp, Jan K. Buitelaar, Ruud B. Minderaa, Gigi van de Loo-Neus, Rutger-Jan van der Gaag & Pieter J. Hoekstra. Long-term treatment with atomoxetine for attention-deficit/hyperactivity disorder symptoms in children and adolescents with autism spectrum disorder: an open-label extension study. Journal of child and adolescent psychopharmacology. 2013-04, 23 (3): 194–199. PMID 23578015. doi:10.1089/cap.2012.0012. 
  407. ^ 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. 
  408. ^ 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. 
  409. ^ 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=|archive-url=只需其一 (帮助); |accessdate=|access-date=只需其一 (帮助); |archivedate=|archive-date=只需其一 (帮助)
  410. ^ 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. 
  411. ^ Treuer T, Gau SS, Méndez L, Montgomery W, Monk JA, Altin M; 等. 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. 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. 
  412. ^ 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. 
  413. ^