在美国经历创伤性脑损伤的退伍军人中普遍使用中枢神经系统兴奋剂的模式和趋势
Yan Cheng1, Youxuan Ling1, Joel Scholten2
1Veterans Affairs Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA.
The American journal of medicine
|October 19, 2025
概括
在创伤性脑损伤 (TBI) 的退伍军人中,中枢神经系统 (CNS) 兴奋剂的使用率较低,但随着时间的推移而增加. 需要对此种人群中事件使用,安全性和有效性进行进一步的研究.
科学领域:
- 神经科学是一个神经科学.
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性轻度创伤性脑损伤 (TBI) 可以导致类似于注意力缺陷/多动症障碍 (ADHD) 的认知和行为症状.
- 通常用于ADHD的中枢神经系统 (CNS) 兴奋剂通常不推用于TBI,但有时会处方.
- 了解TBI退伍军人的兴奋剂使用模式对于适当的临床管理至关重要.
研究的目的:
- 检查在被诊断患有创伤性脑损伤 (TBI) 的美国退伍军人中普遍使用中枢神经系统 (CNS) 兴奋剂的模式和趋势.
- 为了比较不同时期的兴奋剂使用率:主要的作战行动,战后和COVID-19大流行.
- 分析特定高危子组的兴奋剂使用趋势,包括那些患有阿片类药物使用障碍和ADHD的人.
主要方法:
- 在退伍军人事务 (VA) 医疗保健系统内,从2001年至2023年对一大批患有TBI的美国退伍军人进行分析 (N=966,953).
- 在TBI诊断前六个月内根据处方填充识别流行中枢神经系统兴奋剂使用者 (n=11,710).
- 将退伍军人分为三个时期:2001-2014年 (战斗),2015-2019年 (战后) 和2020-2023年 (COVID-19大流行),以评估时间趋势.
主要成果:
- 患有TBI的10,000名退伍军人中,中枢神经系统兴奋剂的使用率从83人 (2001-2014) 增加到150人 (2015-2019) 和194人 (2020-2023).
- 在以下子组中观察到兴奋剂使用的显著增加:阿片类药物使用障碍 (ASD=11-16%) 和注意力缺陷/多动症障碍 (ASD=3-7%).
- 尽管趋势在增加,但整体使用率仍然很低,特别是与ADHD小组相比.
结论:
- 患有TBI的退伍军人中普遍使用中枢神经系统兴奋剂显示了时间趋势的增加,即使在高风险人群中也是如此.
- 在患有TBI的退伍军人中,使用兴奋剂的总体患病率仍然很低.
- 未来的研究应该调查事件中枢神经系统刺激剂的使用情况,以及在TBI退伍军人中的安全性和有效性.
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