生物与医学2022ncbi.nlm.nih.gov
ADHD 药物与抑郁之间的关联：一项 10 年随访研究
Association between ADHD medication and depression: A 10-year follow-up
入门 · 约 45 分钟读完前置知识：ADHD 基础知识、流行病学研究方法
导读
这篇论文基于瑞典全国登记数据，对 ADHD 患者进行了最长 10 年的随访，研究哌甲酯（methylphenidate）类药物与抑郁风险之间的关联。研究聚焦于哌甲酯这一种 ADHD 药物，探讨长期用药是否与抑郁发生相关。
HN 关注点：ADHD 药物长期使用的安全性，讨论焦点在于标题是否夸大了结论范围，以及个人用药经历与研究的对照。
HN 评论精选
这几条评论里：质疑 1 补充 1 亲历 2
亲历亲历者分享长期服用 Concerta 的正面经历，认为药物极大改善了自己的生活。
个人经历：我从 7 岁起服用哌甲酯（Concerta），21 年过去，事业顺利、家庭朋友关系良好，整体很幸福。大学时曾尝试停药，几个月内生活几乎崩塌——差点和女友分手、挂科、疏远朋友。Concerta 不能治愈 ADHD，但让它变得可控。我很庆幸父母没有因为'给孩子吃药不好'这种过时观念而让我硬扛，这药对我效果极好。
tjridesbikes查看英文原文
Anecdata, but I've been on methylphenidate (Concerta) since age 7, and holy cow has it impacted my life in an insanely positive way. 21 years later, I'm still on Concerta, but excelling in my career, spending meaningful time with friends, family, and hobbies, and generally pretty happy with myself. When I tried dropping the meds in college, my life basically fell apart in a matter of months. My then-girlfriend now-wife almost broke up with me, I started failing classes, I lost contact with friends, and really struggled to feel alive. The Concerta doesn't fix my ADHD, but wow does it make it manageable. Thankfully, I had a supportive and invested family, understanding friends, and support structures all around me. I'm so glad my parents put me on meds instead of making me struggle throughout my childhood due to an outdated believe that "drugging kids bad". I owe my life and success to this drug, and while it doesn't work perfectly for everyone diagnosed with ADHD, it works so well for me that you'd have to pry my prescription from my cold, dead hands.
质疑指出标题以偏概全，研究仅涉及哌甲酯，不应泛化为所有 ADHD 药物。
这项研究只针对哌甲酯这一种 ADHD 药物，而 ADHD 处方药有很多种。标题应相应调整，目前的标题含糊且可能误导。
frigate查看英文原文
This study focused specifically on methylphenidate, one of many medications prescribed for ADHD. The title should be adjusted accordingly, as the current title is ambiguous and potentially misleading.
亲历以亲身经历讽刺过度用药的诊断链条，环境因素也可能被误判为药物副作用。
我服用 ADHD 药物后出现抑郁，医生给我加了抗抑郁药，无效后又加抗精神病药。我 12 岁，定期验血以监测已知的肝肾副作用。结果发现，我只是不喜欢住在佛罗里达。
throwaway892238查看英文原文
When I was on ADHD medication and developed depression, they gave me ADHD meds + anti-depressants. When those didn't work they added anti-psychotics. I was 12 years old, getting my blood checked regularly to try to detect the liver or kidney failure (I don't remember which) they knew was a side-effect. Turned out I just didn't like living in Florida.
补充提醒 ADHD 本身就是抑郁的风险因素，相关不等于因果。
顺带一提，ADHD 本身也会增加抑郁风险。执行功能障碍会带来大量'我是个废物''我永远无法成功'之类的内心想法。而且公平地说，别人也会把这类想法直接说给 ADHD 患者听。
falcolas查看英文原文
FWIW, ADHD increases the risk of depression too. Executive Function Disorder creates a lot of internal thoughts of "I'm a loser" "I'll never be able to succeed", and so forth. Though, being fair, those are thoughts other people will direct at those with ADHD as well.
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