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非中枢神经兴奋剂托莫西汀在国内的上市,为注意缺陷多动障碍(ADHD)的药物治疗提供了新的选择。托莫西汀是去甲肾上腺素递质再摄取抑制剂,能选择性抑制突触前去甲肾上腺素转运蛋白,增强去甲肾上腺素的翻转效应,延长在突触裂隙释放的去甲肾上腺素的活性,从而达到改善ADHD患者的症状。与中枢神经兴奋剂哌甲酯相比,因其并不影响多巴胺神经递质的浓度,故不致诱导抽动或加重运动障碍,因而更适宜ADHD合并抽动障碍的患儿选用。文章还就托莫西汀治疗ADHD的适应证、用药剂量调整方法以及不良反应和疗效评估等问题作了概述。
The non-central nervous system stimulant atomoxetine is marketed domestically, which provides a new option for drug treatment of attention deficit hyperactivity disorder (ADHD). Tomoxetine is a norepinephrine reuptake inhibitor that selectively inhibits the presynaptic norepinephrine transporter, enhances the turnover effect of norepinephrine, prolongs the release of norepinephrine in the synaptic cleft Activity, so as to improve the symptoms of ADHD patients. And central nervous system stimulant methylphenidate, because it does not affect the concentration of dopamine neurotransmitters, it will not induce tic or aggravating dyskinesia, and therefore more suitable ADHD with tic disorder in children selected. The article also outlined the indications for the treatment of ADHD with tomoxetine, dosage adjustment methods, as well as adverse reactions and efficacy evaluation.