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Übersichtsarbeiten/Review articles

Aufmerksamkeitsdefizit-Hyperaktivitätsstörung (ADHS) und Straßenverkehr

Was gibt es in der Behandlung Jugendlicher mit ADHS zu beachten?

Published Online:https://doi.org/10.1024/1422-4917.37.5.405

Die Aufmerksamkeitsdefizit-Hyperaktivitätsstörung (ADHS) besteht bei ca. einem Drittel der Betroffenen auch noch in der Adoleszenz und im jungen Erwachsenenalter fort. Relevante Auswirkungen der Störung können die weiterhin bestehende Unaufmerksamkeit, Konzentrationsschwäche und auch gesteigertes impulsives Verhalten im Straßenverkehr sein: Jugendliche und junge Erwachsene mit ADHS verursachen im Vergleich zu Gleichaltrigen insgesamt mehr als doppelt so häufig Verkehrsunfälle mit Kraftfahrzeugen. In dieser Übersichtsarbeit soll ein kurzer Abriss der rechtlichen Situation und der aktuellen Studienlage zum Fahrverhalten von jungen Menschen mit ADHS gegeben werden. Stimulanzien gehören nach der Straßenverkehrsordnung (StVO) zu den verbotenen Rauschmitteln, verbessern aber nach heutiger Studienlage die Fahrleistung von ADHS-Patienten signifikant. Für Atomoxetin, das als nicht BtM-rezeptpflichtiges Arzneimittel problemlos gegeben werden kann, da es nicht in der StVO aufgeführt ist, sind die Forschungsergebnisse noch nicht so eindeutig. Die Psychoedukation jugendlicher ADHS Betroffener bezüglich ihres erhöhten Risikos im Straßenverkehr, Verhaltensempfehlungen und Aufklärung über die rechtliche Lage werden in der klinischen Praxis oft vernachlässigt. Unter dem Gesichtspunkt der Prävention ist eine Beratung aber angesichts der hohen Zahlen der Verkehrstoten in dieser Altersgruppe von höchster Relevanz.


Attention Deficit Hyperactivity Disorder (ADHD) and road traffic – special considerations for the treatment of adolescents with ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is not only a childhood disorder but symptoms persist into adolescence and adulthood in approximately one third of the patients. Especially inattention and poor concentration impair driving performance in road traffic. Adolescents and young adults with ADHD are twice as likely to be involved in traffic accidents as people of the same age. This review sums up the legal situation in Germany and provides an overview of the current existing experimental studies on driving performance of adolescents and young adults with ADHD. Psychostimulant therapy seems to improve driving performance in ADHD patients. At the same time psychostimulants are prohibited, according to the road traffic act. Atomoxetine as a non-stimulant is not mentioned there. Therefore it could be unproblematically prescribed, however, the evidence for improved driving is not as unequivocal as for methylphenidate. The psychoeducation of adolescents and young adults with ADHD concerning their increased risk in road traffic often seems to be insufficient in clinical practice. Given the high number of traffic deaths in these young age groups consulting regarding this matter should be of high priority.

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