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首页> 美国卫生研究院文献>Innovations in Clinical Neuroscience >Major Depression with ADHD
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Major Depression with ADHD

机译：多动症导致的严重抑郁

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The objective of this paper is to review recent studies on comorbidity and treatment of major depression (MD) and attention deficit/hyperactivity disorder (ADHD) in children and adolescents. Both ADHD and MD are commonly associated with other DSM-IV Axis I psychiatric disorders. ADHD is more commonly associated with oppositional defiant disorder and conduct disorder in children and adolescents. The literature on comorbidities of MD and ADHD suggests that when these two disorders occur together, they bring their own unique profiles, often including a number of other psychiatric disorders and severe symptoms. The guidelines for the use of first-line ADHD medications (psychostimulants and atomoxetine) and the use of antidepressants in patients with MD comorbid with ADHD (with and without psychostimulants) will also be reviewed. Recommendations for the sequencing of these medications in patients with comorbid MD and ADHD and other disorders (anxiety disorders, oppositional defiant disorder, conduct disorder) will also be made. The concept of “goodness of fit” as it applies to medication choices will also be outlined. Some antidepressants, such as imipramine, desipramine, and bupropion have been effective in treating major depression, anxiety disorders, and ADHD in adults. Tricyclic antidepressants have not been as effective in treating MD in children and adolescents; however, they can be used to treat adults with ADHD and MD. Some of the SSRIs are proven to be effective and safe in children and adolescents and can be considered in patients with comorbid MD and ADHD.
机译：本文的目的是回顾有关儿童和青少年严重抑郁症（MD）和注意缺陷/多动障碍（ADHD）的合并症和治疗的最新研究。 ADHD和MD通常都与其他DSM-IV Axis I精神病相关。 ADHD更常见于儿童和青少年的对立挑衅障碍和行为障碍。关于MD和ADHD合并症的文献表明，当这两种疾病同时发生时，它们具有各自独特的特征，通常包括许多其他精神疾病和严重症状。一线多动症药物（精神兴奋剂和阿莫西汀）的使用指南以及患有多动症的MD患者（有或没有精神兴奋剂）使用抗抑郁药的指南也将得到审查。对于合并性MD和ADHD以及其他疾病（焦虑症，对立违抗性疾病，行为障碍）的患者，将对这些药物的测序提出建议。也将概述适用于药物选择的“适合度”的概念。某些抗抑郁药，例如丙咪嗪，地昔帕明和安非他酮，已经有效地治疗了成年人的严重抑郁症，焦虑症和多动症。三环类抗抑郁药在治疗儿童和青少年的MD方面没有那么有效；但是，它们可以用于治疗患有ADHD和MD的成年人。一些SSRI已被证明对儿童和青少年有效且安全，可以在MD和ADHD合并症患者中考虑使用。

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