????????(ADHD) ~????~ - PowerPoint PPT Presentation

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Title:

????????(ADHD) ~????~

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Title: Consensus of ADHD Treatment Guideline Author: Gau Last modified by: SONY Created Date: 9/4/2007 10:01:58 AM – PowerPoint PPT presentation

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Title: ????????(ADHD) ~????~

1
????????(ADHD)????

???? ???
? ? ? ? ?
103.9.27

2
????DSM-5

???????????
????????/??,???????
DSM-IV?ADHD???????
??????
??/???
???
??????12??????,???6???????,???????????????????????
???ADHD??,??????????????????????(American
Psychiatric Association, 2013)

3
??????ADHD?

????? ??/??
???? ????,????
????? ???????
??????? ???????????
???????? ?????
??????? ???????????
??????? ??
???? ??????
???? ????????
?? ?????????

4
??????ADHD?

?????
??????????????
????? ?????????
??
??????????
?????
????(???)
??
????????
???????

5
????_????
Source Zametkin et al, Archives of General
Psychiatry, 1990
6
ADHD???????

????????????
???
??????
??????
?????????
??,??
??????
????????

7
?????-1

????????????,?????
???????????????????
???????????,????
?????????????
???????????????
???????????
?????????????????

8
?????-2

???????,?????,???????
??????????????
?????????????????????!
?????????????,?????,?????????????????
???????????????

9
?????????
10
? ? ? ?

??(FDA??)
????(????)
???????
ADHD??????????? ???? gtgt???? ? ??
ADHD???????????
???????gt????gt????gt??

11
ADHD???????
12
? ? ? ?

????????????ADHD??? (FDA approved) ?
???????Methylphenidate (MPH) (Gau et al.,
2006a,b 2007b)
???MPH(IR MPH, Ritalin ???)
???MPH(OROS MPH, Concerta ???)
????????Atomoxetine (Strattera ??) (Gau et al.,
2007a)

13
??????? (Methylphenidate)

??
?????? (Ritalin, ???, 10 mg)
?????????1?2???
????3?4??
????2-3?
?????? (Concerta, ???, 18/36 mg)
????8?12??
??????

18 mg/cap
36 mg/cap
14

??????
?????,???,??,?????????, ????
?????(???)???
??????????????????
??????????
?????,????,??????
?????????????IR-MPH??????,??????????????????,?????
??????MPH????????,?????,??????????

15
Methylphenidate ???
??????? ?????? ???????????????? ??????? ??????????? ??????? ?????????(?????????)? ????? ???????? ?????? ?????????? ?????????? ???????????
16
Methylphenidate???

???????
????????????
?????????????
??????
???????
?????????
??????????????
??????????????
????????????
???????????
??????????????
??????????????
?????????????????

Back
17
Methylphenidate???

????????,???????????(????????????),????????(Speuce
retal,1996)
?ADHD?ADHD?????????????,????????????????
?ADHD???????,???ADHD?????,??????????????????
??????????ADHD???????,??????????

18
Methylphenidate???????

?????????????
????????????????????????????
???????,????????????????,???????ADHD??,???????????
??
?????
????
????
????
????
????

19
???????? Atomoxetine

Atomoxetine???????????????????????(selective
inhibitor of the presynaptic norepinephrine
transporter)???,????????(????)???,???????????????
Atomoxetine?????ADHD???????????????????(Michelson
et al., 2001, 2002, 2003 Swensen et al., 2001)
?????????????????,???????????,????????(Gau et
al., 2007)

20
? ? ? ?

???????(American Academy of Pediatrics, 2001)
????????(Kutcher et al., 2004)?????????(Pliszka
et al., 2006a)????????????ADHD???????? (????MPH
)?
???Atomoxetine?????
ADHD??Tics ???????????????
?????????????
???24???????

21
????????