[논문]주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(III) - 약물치료 -

김효원; 김은주; 김지훈; 박장호; 반건호; 이연정; 정경운; 신동원

doi:10.5765/jkacap.2017.28.2.70

주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(III) - 약물치료 -
The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (III) - Pharmacological Treatment - 원문보기

소아청소년정신의학 = Journal of the Korean Academy of Child and Adolescent Psychiatry, v.28 no.2, 2017년, pp.70 - 83

Abstract ▼ AI-Helper

The objective of this review is the revision of the Korean practice parameters for the pharmacological treatment of attention-deficit hyperactivity disorder (ADHD) based on the change in the diagnostic system from DSM-IV-TR to DSM-5 and psychopharmacological developments. For the evidence-based approach, the authors conducted a review of the literature, including controlled clinical trials, studies of the side effects of drugs, toxicology and meta-analyses from the United States and Europe, as well as recent research conducted in Korea. The review committee composed of Korean experts on ADHD reviewed the revised parameters. This revised version reveals how to use central nervous system psychostimulants, non-stimulants such as atomoxetine and alpha2 agonists, and other medication for ADHD, and how to manage the adverse effects of such medication. At the end of this revised version, the authors propose recommendations for the pharmacotherapy of ADHD.

주제어

질의응답

핵심어	질문	논문에서 추출한 답변
	ADHD 치료제로 한국 식품의약품안전처의 승인을 받은 약물은?	현재 ADHD 치료제로 한국 식품의약품안전처의 승인을 받은 약물로는 중추신경자극제인 메칠페니데이트(methylphenidate),비중추신경자극제 중에는 아토목세틴(atomoxetine)과 α2-agonist 계열 약물인 클로니딘(clonidine)이 있다. 그 외 삼환계 항우울제(tricyclic antidepressants)와 부프로피온(bupropion)이 ADHD 증상을 호전시키는 것으로 알려져 있지만 식품의약품안전처의 승인을 받지 못해 off-label로만 사용이 가능하다.
	주의력결핍 과잉행동장애 치료 초기 또는 기능상 문제가 심하지 않은 경우 우선 시행하는 치료는?	주의력결핍 과잉행동장애(attention-deficit hyperactivity disorder, ADHD)의 치료에서는 약물치료와 비약물치료가 상호보완적인 역할을 한다. 치료 초기 또는 기능상 문제가 심하지 않은 경우 비약물치료를 우선 시행할 수 있으나, 기능상 문제가 상당한 경우라면 치료 초기부터 약물치료가 필요하다. ADHD의 병태생리와 중추신경자극제의 약리학적 기전에 대한 연구들이 활발히 이루어지고, Multimodal Treatment of Attention-Deficit Hyperactivity Disorder Study(MTA) 연구에서 약물치료가 행동치료보다 ADHD 증상 호전에서 우월한효과를 보이는 것이 알려지면서,1) 현재는 약물치료가 ADHD의 일차적인 치료로 생각되고 있다.
	중추신경자극제의 특징은?	중추신경자극제는 전전두피질의 도파민과 노르아드레날린, 선조체의 도파민 세포외 농도(extracellular concentration)를 증가시키는 약물로 부주의, 과잉행동, 충동성 같은 ADHD핵심 증상을 호전시킬 뿐 아니라 문제행동을 줄여주며 학업능력을 증진하고 적절한 교우관계를 유지하는 데에 도움이 된다. ADHD 아동을 대상으로 한 대규모 약물연구인 MTA 연구에서는 중추신경자극제의 사용으로 ADHD의 증상이 효과적으로 호전되었으며, 약 70%에서 치료 반응을 보였다.

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저자의 다른 논문 :

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동의어: Packet Collision Rate

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