Aman Michael G
Nisonger Center, Ohio State University, Columbus, OH 43210-1296, USA.
Semin Pediatr Neurol. 2004 Sep;11(3):225-8. doi: 10.1016/j.spen.2004.07.006.
Hyperactivity/impulsivity, aggression, self injury, and irritability are disruptive behaviors that frequently accompany autism spectrum disorders (ASD). The psychostimulants and atypical antipsychotics have been used with some success to manage hyperactivity, but neither drug group is fully satisfactory and clinical response to the stimulants varies. For other disruptive symptoms (irritability, aggression, self injury), both older antipsychotics and newer atypical antipsychotics have been shown to have helpful effects. Because of potential side effects, atypical antipsychotics should ordinarily be preferred over older agents. A small group of studies suggests that selective serotonin reuptake inhibitors may be helpful in managing symptoms related to aggression, self injury, and the like. A small and largely imperfect literature suggests that beta blockers, mood stabilizers, and alpha-2 agonists may also have some role for treating such symptoms. More research is needed on the management of all of these target symptoms, both for new agents (e.g., atomoxetine) and for established psychoactive medicines.
多动/冲动、攻击行为、自我伤害和易怒是自闭症谱系障碍（ASD）常伴有的破坏性行为。精神兴奋剂和非典型抗精神病药物在治疗多动方面已取得一定成功，但这两类药物都不尽人意，且对兴奋剂的临床反应存在差异。对于其他破坏性行为症状（易怒、攻击行为、自我伤害），已证明 older antipsychotics（此处原文有误，可能是“传统抗精神病药物”）和新型非典型抗精神病药物均有帮助作用。由于存在潜在副作用，通常应优先选择非典型抗精神病药物而非 older agents（此处原文有误，可能是“传统药物”）。一小部分研究表明，选择性5-羟色胺再摄取抑制剂可能有助于控制与攻击行为、自我伤害等相关的症状。一小部分且在很大程度上并不完善的文献表明，β受体阻滞剂、心境稳定剂和α-2激动剂在治疗此类症状方面可能也有一定作用。对于所有这些目标症状的管理，无论是新型药物（如托莫西汀）还是已有的精神活性药物，都需要进行更多研究。
