Ceranoglu Tolga Atilla, Wozniak Janet, Fried Ronna, Galdo Maribel, Hoskova Barbora, DeLeon Fong Melissa, Biederman Joseph, Joshi Gagan
1 Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital , Boston, Massachusetts.
2 Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital , Boston, Massachusetts.
J Child Adolesc Psychopharmacol. 2019 Feb;29(1):28-33. doi: 10.1089/cap.2018.0021. Epub 2018 Nov 16.
Anxiety disorders (ADs) are commonly associated with high-functioning Autism Spectrum Disorder (HF-ASD) and often worsen with age. Buspirone is a commonly prescribed anxiolytic drug with a favorable tolerability profile that may offer potential benefits in anxiety management for patients with HF-ASD. This study examines inadequately explored tolerability and effectiveness of buspirone in treating ADs comorbid with high-functioning ASD.
A retrospective chart review of a 1-year period was conducted in psychiatrically referred population of HF-ASD youth with AD (age 8-17 years) who were treated with buspirone (N = 31). Information on the demographics and treatment history was recorded. Effectiveness was assessed through the Clinical Global Impressions Scale (CGI) severity (CGI-S) and improvement (CGI-I) scores noted by the treating clinician.
A total of 31 patients were prescribed buspirone during the determined period, at a mean dose of 41.61 ± 24.10 mg for an average duration of 272 ± 125 days. Change in the CGI-S mean scores with treatment suggests an overall improvement in the severity of anxiety symptoms (M = 4.9 ± 0.7; M = 2.8 ± 0.87; p < 0.001). Significant improvement in anxiety symptoms (CGI-I ≤ 2) was observed in 58% and mild improvement (CGI-I = 3) in 29% of the HF-ASD patients who received buspirone treatment. Buspirone was well tolerated with no adverse events reported by the majority of participants, with the exception of two subjects who developed treatment emergent adverse events (activation and mood lability).
Findings from this retrospective chart review suggest a promising role of buspirone in managing anxiety among youth with HF-ASD. Further research with prospective and randomized-controlled trials is necessary.
焦虑症(ADs)通常与高功能自闭症谱系障碍(HF-ASD)相关,且常随年龄增长而恶化。丁螺环酮是一种常用的抗焦虑药物,耐受性良好,可能对HF-ASD患者的焦虑管理有潜在益处。本研究探讨丁螺环酮在治疗与高功能ASD共病的ADs方面尚未充分研究的耐受性和有效性。
对1年期间转诊至精神科的患有ADs的HF-ASD青少年(年龄8 - 17岁)进行回顾性病历审查,这些青少年接受了丁螺环酮治疗(N = 31)。记录人口统计学和治疗史信息。通过治疗医生记录的临床总体印象量表(CGI)严重程度(CGI-S)和改善程度(CGI-I)评分评估有效性。
在确定的时间段内,共有31名患者服用丁螺环酮,平均剂量为41.61±24.10毫克,平均疗程为272±125天。治疗后CGI-S平均评分的变化表明焦虑症状严重程度总体有所改善(M = 4.9±0.7;M = 2.8±0.87;p < 0.001)。在接受丁螺环酮治疗的HF-ASD患者中,58%的患者焦虑症状有显著改善(CGI-I≤2),29%的患者有轻度改善(CGI-I = 3)。丁螺环酮耐受性良好,大多数参与者未报告不良事件,只有两名受试者出现治疗中出现的不良事件(兴奋和情绪不稳定)。
本次回顾性病历审查的结果表明丁螺环酮在管理HF-ASD青少年的焦虑方面有潜在作用。有必要进行进一步的前瞻性和随机对照试验研究。