Doyle Carolyn A, McDougle Christopher J
Department of Psychiatry, Harvard Medical School; Lurie Center for Autism, Massachusetts General Hospital, Boston, MA, USA.
Dialogues Clin Neurosci. 2012 Sep;14(3):263-79. doi: 10.31887/DCNS.2012.14.3/cdoyle.
This review outlines pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders (ASDs) in children, adolescents, and adults. Symptom domains include repetitive and stereotyped behaviors, irritability and aggression, hyperactivity and inattention, and social impairment. Medications covered include serotonin reuptake inhibitors (SRIs), mirtazapine, antipsychotics, psychostimulants, atomoxetine, α-2 agonists, D-cycloserine, and memantine. Overall, SRIs are less efficacious and more poorly tolerated in children with ASDs than in adults. Antipsychotics are the most efficacious drugs for the treatment of irritability in ASDs, and may be useful in the treatment of other symptoms. Psychostimulants demonstrate some benefit for the treatment of hyperactivity and inattention in individuals with ASDs, but are less efficacious and associated with more adverse effects compared with individuals with ADHD. D-cycloserine and memantine appear helpful in the treatment of social impairment, although further research is needed.
本综述概述了针对儿童、青少年和成人自闭症谱系障碍（ASD）相关行为症状的药物治疗。症状领域包括重复刻板行为、易激惹和攻击行为、多动和注意力不集中以及社交障碍。涵盖的药物包括5-羟色胺再摄取抑制剂（SRI）、米氮平、抗精神病药物、精神兴奋剂、托莫西汀、α-2激动剂、D-环丝氨酸和美金刚。总体而言，与成人相比，SRI在ASD儿童中的疗效较低且耐受性较差。抗精神病药物是治疗ASD易激惹最有效的药物，可能对治疗其他症状也有用。精神兴奋剂对治疗ASD患者的多动和注意力不集中有一定益处，但与患有注意力缺陷多动障碍（ADHD）的个体相比，疗效较差且不良反应更多。D-环丝氨酸和美金刚似乎有助于治疗社交障碍，不过仍需进一步研究。
