Comorbidity of attention deficit hyperactivity disorder and alcohol use disorders in adults: Neurobiological mechanisms and modern approaches to therapy (literature review)

Introduction. Attention deficit hyperactivity disorder (ADHD) and alcohol use disorders (AUD) are common and clinically significant conditions that often occur concurrently and inevitably reduce the quality of life. In individuals with ADHD, the risk of developing AUD is significantly higher than in the general population, which is due to universal neu-robiological, behavioral and psychosocial mechanisms. Objective: to summarize current data on the prevalence, patho-genesis, diagnosis and approaches to the treatment of ADHD and AUD comorbidity. Methods. A review of the scien-tific literature published in the PubMed, Scopus and RSCI scientometric databases was conducted, with an emphasis on the epidemiological, neurobiological, psychosocial and clinical diagnostic aspects of the interaction between ADHD and AUD. The paper includes English-language publications from 2000 to 2024, as well as Russian-language sources cover-ing domestic experience in studying the problem. Results. The key factors contributing to the formation of comorbidity were identified: dopaminergic dysfunction, impulsivity, emotional dysregulation, stress effects, and disturbances in par-ent-child relationships. The difficulties in diagnosing ADHD in patients with AUD due to symptomatic overlap and cog-nitive impairment against the background of alcohol withdrawal were noted. The need for routine screening and integra-tion of ADHD treatment into drug treatment practice was substantiated. Multimodal approaches were recognized as the most effective, including pharmacotherapy (including non-stimulating drugs without central nervous system activation and anti-craving agents to reduce cravings for psychoactive substances) and psychotherapeutic interventions (cognitive behavioral therapy as a tool for developing coping strategies). Conclusion. The comorbidity of ADHD and AUD re-quires a comprehensive interdisciplinary approach, including early diagnosis, individualized therapy to optimize treat-ment, and the elimination of systemic barriers to inpatient and outpatient psychiatric care. Future research should be aimed at clarifying the pathogenesis, developing personalized treatment strategies, and implementing comprehensive prevention programs in high-risk groups.