Nicolson Rob, Craven-Thuss Beth, Smith Judy
Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.
J Child Adolesc Psychopharmacol. 2006 Oct;16(5):621-9. doi: 10.1089/cap.2006.16.621.
Post-mortem studies have reported abnormalities of the cholinergic system in autism. The purpose of this study was to assess the use of galantamine, an acetylcholinesterase inhibitor and nicotinic receptor modulator, in the treatment of interfering behaviors in children with autism.
Thirteen medication-free children with autism (mean age, 8.8 +/- 3.5 years) participated in a 12-week, open-label trial of galantamine. Patients were rated monthly by parents on the Aberrant Behavior Checklist (ABC) and the Conners' Parent Rating Scale-Revised, and by a physician using the Children's Psychiatric Rating Scale and the Clinical Global Impressions scale.
Patients showed a significant reduction in parent-rated irritability and social withdrawal on the ABC as well as significant improvements in emotional lability and inattention on the Conners' Parent Rating Scale--Revised. Similarly, clinician ratings showed reductions in the anger subscale of the Children's Psychiatric Rating Scale. Eight of 13 participants were rated as responders on the basis of their improvement scores on the Clinical Global Impressions scale. Overall, galantamine was well-tolerated, with no significant adverse effects apart from headaches in one patient.
In this open trial, galantamine was well-tolerated and appeared to be beneficial for the treatment of interfering behaviors in children with autism, particularly aggression, behavioral dyscontrol, and inattention. Further controlled trials are warranted.
尸检研究报告了自闭症患者胆碱能系统存在异常。本研究的目的是评估加兰他敏（一种乙酰胆碱酯酶抑制剂和烟碱受体调节剂）在治疗自闭症儿童干扰行为中的应用。
13名未服用过药物的自闭症儿童（平均年龄8.8±3.5岁）参与了一项为期12周的加兰他敏开放标签试验。父母每月使用异常行为检查表（ABC）和修订版康纳斯父母评定量表对患者进行评分，医生则使用儿童精神病评定量表和临床总体印象量表进行评分。
在ABC量表上，父母评定的患者易怒和社交退缩症状显著减轻，在修订版康纳斯父母评定量表上，情绪不稳定和注意力不集中症状也有显著改善。同样，临床医生的评分显示儿童精神病评定量表的愤怒分量表得分降低。根据临床总体印象量表的改善得分，13名参与者中有8名被评为有反应者。总体而言，加兰他敏耐受性良好，除一名患者出现头痛外，无明显不良反应。
在这项开放试验中，加兰他敏耐受性良好，似乎对治疗自闭症儿童的干扰行为有益处，尤其是攻击行为、行为失控和注意力不集中。有必要进行进一步的对照试验。
