TRATAMIENTO DEL TDAH EN ADULTOS: EFICACIA COMPARATIVA ENTRE ENFOQUES FARMACOLÓGICOS Y NO FARMACOLÓGICOS
DOI:
https://doi.org/10.56238/levv17n59-043Palabras clave:
Trastorno por Déficit de Atención e Hiperactividad (TDAH), TDAH en Adultos, Farmacoterapia, Psicoestimulantes, Metilfenidato, Terapia Cognitivo-Conductual, Neurofeedback, Intervenciones No Farmacológicas, Tratamiento Multimodal, Comorbilidades PsiquiátricasResumen
El trastorno por déficit de atención con hiperactividad (TDAH) persiste en la edad adulta en el 50 al 60% de los casos, lo que conlleva importantes limitaciones funcionales y una alta prevalencia de comorbilidades. Este estudio consistió en una revisión narrativa de la literatura con el objetivo de comparar la efectividad de los enfoques farmacológicos y no farmacológicos en el tratamiento del TDAH en adultos. La búsqueda se realizó en las bases de datos PubMed, Scopus, Web of Science y ScienceDirect, lo que resultó en la inclusión de 10 estudios tras aplicar los criterios de elegibilidad. Los resultados indican que los psicoestimulantes —metilfenidato y lisdexanfetamina— siguen siendo la terapia de primera línea, con una sólida eficacia en la reducción de los síntomas principales. La atomoxetina destaca como una alternativa no estimulante, especialmente en pacientes con riesgo de abuso de sustancias. Entre las intervenciones no farmacológicas, la terapia cognitivo-conductual (TCC) mostró los resultados más consistentes, seguida del neurofeedback, el entrenamiento de autoalerta (SAT), la atención plena, la fototerapia y el ejercicio físico. El análisis resalta la complementariedad entre ambas modalidades: mientras que los fármacos actúan con mayor rapidez sobre los síntomas principales, las intervenciones psicosociales promueven la autorregulación, la adherencia al tratamiento y el manejo de las comorbilidades. Concluye que el tratamiento debe ser individualizado y, preferiblemente, multimodal, integrando la farmacoterapia y las intervenciones no farmacológicas. Sin embargo, se enfatiza la necesidad de ensayos clínicos aleatorizados con mayor rigor metodológico para respaldar guías clínicas más completas.
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