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广泛性发育障碍的治疗管理选项。

Treatment options for the management of pervasive developmental disorders.

作者信息

Nash Kathryn, Carter K Jennifer

机构信息

Department of Clinical Pharmacy Services, Greenville Health System, Greenville, SC, USA

Department of Clinical Pharmacy Services, Greenville Health System, Greenville, SC, USA.

出版信息

Int J Psychiatry Med. 2016;51(2):201-10. doi: 10.1177/0091217416636600.

Abstract

Autism spectrum disorder (previously known as pervasive developmental disorders) is characterized by social communication deficits, impaired functioning, and restrictive or repetitive behaviors and interests. Patients with autism spectrum disorder also commonly experience core maladaptive behaviors such as aggression and irritability, self-injurious behaviors, hyperactivity, and sleep abnormalities. These behaviors may be sources of stress for caregivers and patients alike and may require pharmacologic management. Risperidone and aripiprazole are frequently used to treat both irritability and self-injurious behavior related to autism spectrum disorder. The opioid antagonist naltrexone has also been studied for self-injurious behaviors, although long-term data are lacking when used in the autism spectrum disorder population. Methylphenidate, atomoxetine, clonidine, and guanfacine are all potential options for the treatment of hyperactivity or attention-deficient hyperactivity disorder-like symptoms in patients with autism spectrum disorder. Lastly, melatonin is the most widely researched medication strategy for the management of sleep disorders in autism spectrum disorder. Future studies reviewing new pharmacologic treatment approaches in combination with non-pharmacologic therapies are warranted to ensure that target behaviors of autism spectrum disorder are appropriately managed.

摘要

自闭症谱系障碍(以前称为广泛性发育障碍)的特征是社交沟通缺陷、功能受损以及存在局限或重复的行为和兴趣。自闭症谱系障碍患者通常还会出现核心适应不良行为,如攻击性行为和易怒、自伤行为、多动以及睡眠异常。这些行为可能对照顾者和患者来说都是压力源,可能需要药物治疗。利培酮和阿立哌唑常用于治疗与自闭症谱系障碍相关的易怒和自伤行为。阿片类拮抗剂纳曲酮也已针对自伤行为进行了研究,不过在自闭症谱系障碍人群中使用时缺乏长期数据。哌甲酯、托莫西汀、可乐定和胍法辛都是治疗自闭症谱系障碍患者多动或注意力缺陷多动障碍样症状的潜在选择。最后,褪黑素是针对自闭症谱系障碍睡眠障碍研究最广泛的药物治疗策略。有必要开展未来研究,审视新的药物治疗方法与非药物疗法相结合的情况,以确保自闭症谱系障碍的目标行为得到妥善管理。

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