Malone Richard P, Gratz Silvia S, Delaney Mary Anne, Hyman Susan B
Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA 19124-8358, USA.
CNS Drugs. 2005;19(11):923-34. doi: 10.2165/00023210-200519110-00003.
Autism is a disorder characterised by abnormalities in language and social development, and repetitive behaviours. Antipsychotics, including haloperidol and risperidone, are the most widely studied drugs for reducing symptoms in children and adolescents with autism. When administered at relatively low dosages, antipsychotics have been shown to reduce repetitive behaviours (stereotypies) and social withdrawal, as well as a number of related symptoms, such as hyperactivity, aggression, self-abusive behaviour, temper tantrums, lability of mood and irritability. Adverse effects of antipsychotics include sedation, dizziness, increased appetite, weight gain, changes in the electrocardiogram parameters, drooling, hyperprolactinemia and a risk of drug-related dyskinesias. Other agents have been less well studied for the treatment of autism, but there are suggestive data regarding their safety and efficacy. Of these agents, a number have been investigated, based on theories about the aetiology of autism, including SSRIs and naltrexone, although the efficacy of these agents has been limited. Stimulant drugs have been shown to reduce hyperactivity and improve focus, but they may cause behavioural worsening, weight loss and stereotypies de novo. Secretin is a treatment that has received much media attention after reports of efficacy from small open studies, but all controlled studies have failed to show any benefit. In autism, alternative treatments have also been used, but none have shown benefit in well-designed studies.
自闭症是一种以语言和社交发展异常以及重复行为为特征的疾病。抗精神病药物，包括氟哌啶醇和利培酮，是针对减轻自闭症儿童和青少年症状研究最为广泛的药物。当以相对低剂量给药时，抗精神病药物已被证明可减少重复行为（刻板动作）和社交退缩，以及一些相关症状，如多动、攻击行为、自伤行为、发脾气、情绪不稳定和易怒。抗精神病药物的不良反应包括镇静、头晕、食欲增加、体重增加、心电图参数改变、流涎、高催乳素血症以及药物相关运动障碍的风险。其他药物在治疗自闭症方面的研究较少，但有关于其安全性和疗效的提示性数据。在这些药物中，基于自闭症病因学理论，已经对一些药物进行了研究，包括选择性5-羟色胺再摄取抑制剂（SSRIs）和纳曲酮，尽管这些药物的疗效有限。兴奋剂药物已被证明可减少多动并改善注意力，但它们可能导致行为恶化、体重减轻和出现新的刻板动作。促胰液素在一些小型开放性研究报道其疗效后受到了媒体的广泛关注，但所有对照研究均未显示出任何益处。在自闭症治疗中，也使用了其他替代疗法，但在设计良好的研究中均未显示出益处。
