Wasserman Stacey, Iyengar Rupa, Chaplin William F, Watner Dryden, Waldoks Shulamit E, Anagnostou Evdokia, Soorya Latha, Hollander Eric
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
Int Clin Psychopharmacol. 2006 Nov;21(6):363-7. doi: 10.1097/01.yic.0000224787.13782.0f.
The purpose of this study was to determine the safety and efficacy of the anticonvulsant levetiracetam in the treatment of children with autism. A previous open-label study in autistic children treated with levetiracetam demonstrated effectiveness in hyperactivity, impulsivity/aggression, and mood lability. Twenty patients with autism ranging from 5 to 17 years of age were entered into a 10-week, placebo-controlled, double-blind trial of levetiracetam versus placebo. The mean maximum dosage for levetiracetam was 862.50+/-279.19 mg/day. We evaluated global improvement of autism with the Clinical Global Impression-Improvement (CGI-I) Scale and aggression and affective instability with the Aberrant Behavior Checklist (ABC) parent and teacher ratings. We measured repetitive behaviors using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score and impulsivity and hyperactivity with the Conners' Rating Scale-Revised: Long Version for parent and teacher. No significant difference was found between levetiracetam and placebo groups comparing the change in CGI-I (t=0.350, d.f.=13.621, P=0.765), nor on change in ABC, CY-BOCS or Conners' scales. These findings suggest that levetiracetam does not improve behavioral disturbances of autism, but are limited by the small sample size and lack of stratification of the autistic sample at baseline.
本研究的目的是确定抗惊厥药物左乙拉西坦治疗自闭症儿童的安全性和有效性。先前一项针对接受左乙拉西坦治疗的自闭症儿童的开放标签研究表明,该药物在治疗多动、冲动/攻击行为和情绪不稳定方面有效。20名年龄在5至17岁之间的自闭症患者参与了一项为期10周的、安慰剂对照的、左乙拉西坦与安慰剂对比的双盲试验。左乙拉西坦的平均最大剂量为862.50±279.19毫克/天。我们使用临床总体印象改善量表(CGI-I)评估自闭症的整体改善情况,使用异常行为检查表(ABC)的家长和教师评分评估攻击行为和情感不稳定情况。我们使用儿童耶鲁-布朗强迫量表(CY-BOCS)评分测量重复行为,使用康纳斯修订评定量表:家长和教师用长版测量冲动和多动情况。在比较CGI-I量表变化(t = 0.350,自由度 = 本研究的目的是确定抗惊厥药物左乙拉西坦治疗自闭症儿童的安全性和有效性。先前一项针对接受左乙拉西坦治疗的自闭症儿童的开放标签研究表明,该药物在治疗多动、冲动/攻击行为和情绪不稳定方面有效。20名年龄在5至17岁之间的自闭症患者参与了一项为期10周的、安慰剂对照的、左乙拉西坦与安慰剂对比的双盲试验。左乙拉西坦的平均最大剂量为862.50±279.19毫克/天。我们使用临床总体印象改善量表(CGI-I)评估自闭症的整体改善情况,使用异常行为检查表(ABC)的家长和教师评分评估攻击行为和情感不稳定情况。我们使用儿童耶鲁-布朗强迫量表(CY-BOCS)评分测量重复行为,使用康纳斯修订评定量表:家长和教师用长版测量冲动和多动情况。在比较CGI-I量表变化(t = 0.350,自由度 = 13.621,P = 0.765)时,左乙拉西坦组和安慰剂组之间未发现显著差异,在ABC量表、CY-BOCS量表或康纳斯量表的变化方面也未发现显著差异。这些研究结果表明,左乙拉西坦并不能改善自闭症的行为障碍,但本研究受样本量小以及基线时自闭症样本缺乏分层的限制。 13.621,P = 0.765)时,左乙拉西坦组和安慰剂组之间未发现显著差异,在ABC量表、CY-BOCS量表或康纳斯量表的变化方面也未发现显著差异。这些研究结果表明,左乙拉西坦并不能改善自闭症的行为障碍,但本研究受样本量小以及基线时自闭症样本缺乏分层的限制。