Earle Jason F
Armour Academic Center, College of Nursing, Rush University, Chicago, IL, USA.
J Child Adolesc Psychiatr Nurs. 2016 May;29(2):62-71. doi: 10.1111/jcap.12144. Epub 2016 Jun 9.
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that requires a multidisciplinary approach to treatment. Psychopharmacology can play an important role within an array of services to help children and adolescents with ASD.
This article reviews the current evidence supporting the use of various psychiatric medications to treat common symptoms that often compromise functioning: severe irritability, interfering repetitive behaviors, ADHD, anxiety, depression, and sleep dysregulation. Based on the accumulating research, the article also offers practice recommendations.
The article primarily draws on the science generated by investigators from the Research Units on Pediatric Psychopharmacology Autism Network. This body of work consists of randomized controlled trials, meta-analyses, open trials, and review articles.
There are currently no FDA-approved medications to treat the core symptoms of ASD. Consequently, all medications, besides risperidone and aripiprazole for severe irritability, are considered off-label. Additionally, due to reduced levels of effectiveness and higher rates of side effects, more typical medications such as antidepressants and stimulants should be used with caution. However, the evidence indicates that the thoughtful use of psychiatric medication in conjunction with other interventions may be beneficial in helping children and adolescents with ASD thrive at school and home.
自闭症谱系障碍（ASD）是一种复杂的神经发育障碍，需要多学科方法进行治疗。在一系列服务中，精神药理学可为帮助患有ASD的儿童和青少年发挥重要作用。
本文综述了支持使用各种精神科药物治疗常影响功能的常见症状的现有证据，这些症状包括严重易怒、干扰性重复行为、注意力缺陷多动障碍（ADHD）、焦虑、抑郁和睡眠失调。基于不断积累的研究，本文还提供了实践建议。
本文主要借鉴了儿科精神药理学自闭症网络研究单位的研究人员所产生的科学成果。这项工作包括随机对照试验、荟萃分析、开放试验和综述文章。
目前尚无美国食品药品监督管理局（FDA）批准的用于治疗ASD核心症状的药物。因此，除了用于治疗严重易怒的利培酮和阿立哌唑外，所有药物都被视为非适应证用药。此外，由于有效性降低和副作用发生率较高，应谨慎使用如抗抑郁药和兴奋剂等更传统的药物。然而，有证据表明，谨慎使用精神科药物并结合其他干预措施可能有助于患有ASD的儿童和青少年在学校和家庭中茁壮成长。
