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EFICACIA DE LAS DROGAS ESTIMULANTES Y NO ESTIMULANTES PARA EL TRATAMIENTO DE LOS ADOLESCENTES CON TRASTORNO POR DEFICIT DE ATENCION E HIPERACTIVIDAD

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Es probable que tanto los fármacos estimulantes como los no estimulantes sean tan efectivos para el tratamiento de los adolescentes con trastorno por déficit de atención e hiperactividad como lo son para los niños que sufren dicho trastorno, siempre que el cumplimiento terapéutico sea satisfactorio.
Autor:
Philip Hazell
Columnista Experto de SIIC

Institución:
University of Sydney


Artículos publicados por Philip Hazell
Recepción del artículo
24 de Abril, 2009
Aprobación
15 de Mayo, 2009
Primera edición
1 de Febrero, 2010
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
El objetivo del presente artículo es brindar una actualización de una revisión selectiva publicada con anterioridad sobre la farmacología del trastorno por déficit de atención e hiperactividad (TDAH) en adolescentes. Cerca de la mitad de los niños con TDAH que reciben tratamiento farmacológico presentarán la afección durante la adolescencia, con una intensidad suficiente para requerir la continuidad del tratamiento. Asimismo, una proporción más pequeña de los individuos con TDAH pueden requerir el inicio del tratamiento durante la adolescencia. Las demandas académicas y sociales de la adolescencia pueden exacerbar el deterioro causado por los trastornos atencionales. Además, en comparación con los niños, los adolescentes realizan más actividades que requieren el empleo de sus habilidades atencionales durante la tarde y la noche. Es probable que los fármacos estimulantes y no estimulantes sean tan efectivos para el tratamiento de los adolescentes como lo son para el tratamiento de los niños, siempre que el cumplimiento terapéutico sea satisfactorio. Los fármacos de acción prolongada son preferidos frente a los de acción inmediata, ya que ofrecen un control sintomático superior a lo largo del día. Debe considerarse que los patrones de comorbilidad con TDAH cambian desde la infancia hasta la adolescencia y pueden requerir la modificación de la estrategia terapéutica. La elección del momento de interrupción del tratamiento debería ser conjunta entre el médico y el paciente. La inclusión del paciente en la decisión de interrumpir el tratamiento, seguida por una reevaluación, puede ser útil para evitar una interrupción prematura.

Palabras clave
trastorno por déficit de atención e hiperactividad, adolescencia, tratamiento farmacológico


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Abstract
The aim of the paper is to provide an update to a previously published selective review of the recent literature on the pharmacology of attention-deficit/hyperactivity disorder (ADHD) in adolescents. About one half of children medicated for ADHD will continue to experience sufficient impairment during adolescence to warrant the continuation of their treatment. A smaller number of people with ADHD may require treatment for the first time in adolescence. The academic and social demands of adolescence can exaggerate the impairment caused by attentional problems. Adolescents, more so than children, have activities in the afternoon and evening that will tax their attentional abilities. Stimulant and non-stimulant medications are likely to be as effective for adolescent patients as they are for younger children, provided treatment adherence is satisfactory. Long-acting medications are preferred over immediate release compounds as they provide better coverage of symptoms throughout the day. Patterns of comorbidity with ADHD change from childhood to adolescence and may require a shift in treatment strategy. Picking a time to discontinue treatment should be a decision shared by the clinician and the patient. A negotiated trial off treatment followed by a review can avert premature discontinuation of treatment.

Key words
attention deficit disorder with hyperactivity, adolescent, drug therapy


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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Salud Mental
Relacionadas: Atención Primaria, Farmacología, Medicina Familiar, Medicina Farmacéutica, Neurología, Pediatría



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Enviar correspondencia a:
Philip Hazell, Thomas Walker Hospital (Rivendell) Child, Adolescent and Family Mental Health Service , NSW 2138, Hospital Rd, Concord West, Australia
Bibliografía del artículo


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