重新审视锂盐：对患有自闭症谱系障碍的青少年和成年人行为稳定的效用。
Revisiting Lithium: Utility for Behavioral Stabilization in Adolescents and Adults with Autism Spectrum Disorder.
作者信息
Mintz Mark, Hollenberg Emma
机构信息
Mintz, MD, Hollenberg, The Center for Neurological and Neurodevelopmental Health (CNNH NeuroHealth).
出版信息
Psychopharmacol Bull. 2019 Jun 20;49(2):28-40.
Abstract
OBJECTIVES
To examine the efficacy of lithium as a mood stabilizer for patients with autism spectrum disorder (ASD).
EXPERIMENTAL DESIGN
A retrospective chart review was performed that examined the use of both extended and immediate release lithium carbonate in patients with ASD that were treated at a single clinical center (CNNH NeuroHealth). Clinical Global Impression (CGI) scales were used to quantify baseline severity of ASD and mood symptoms as well as improvement after treatment with lithium carbonate.
PRINCIPLE OBSERVATIONS
Our retrospective chart review found that 73.7% (n = 14) of patients with ASD and concomitant maladaptive behaviors experienced "improvement" (CGI-I rating ≤ 3) with the addition of lithium to their treatment regimen. Those with comorbid "ADHD" phenotype were most predictive of an efficacious response (p = 0.038, Odds Ratio 12.2).
CONCLUSIONS
Lithium carbonate is a viable, efficacious and well tolerated alternative to various neuroleptics and other psychotropic medications for use as a mood stabilizer for patients with ASD.
摘要
目的
研究锂盐作为自闭症谱系障碍（ASD）患者情绪稳定剂的疗效。
实验设计
进行了一项回顾性病历审查，研究在单一临床中心（CNNH神经健康中心）接受治疗的ASD患者中缓释和速释碳酸锂的使用情况。临床总体印象（CGI）量表用于量化ASD和情绪症状的基线严重程度以及碳酸锂治疗后的改善情况。
主要观察结果
我们的回顾性病历审查发现，73.7%（n = 14）患有ASD并伴有适应不良行为的患者在治疗方案中添加锂盐后经历了“改善”（CGI-I评分≤3）。伴有“注意力缺陷多动障碍”（ADHD）表型的患者最能预测有效反应（p = 0.038，优势比12.2）。
结论
对于ASD患者，碳酸锂作为情绪稳定剂，是各种抗精神病药物和其他精神药物的一种可行、有效且耐受性良好的替代品。
相似文献
1
Revisiting Lithium: Utility for Behavioral Stabilization in Adolescents and Adults with Autism Spectrum Disorder.重新审视锂盐：对患有自闭症谱系障碍的青少年和成年人行为稳定的效用。
Psychopharmacol Bull. 2019 Jun 20;49(2):28-40.
2
Post-acute effectiveness of lithium in pediatric bipolar I disorder.锂盐对儿童双相 I 型障碍的急性后期疗效。
J Child Adolesc Psychopharmacol. 2013 Mar;23(2):80-90. doi: 10.1089/cap.2012.0063.
3
Preliminary investigation of lithium for mood disorder symptoms in children and adolescents with autism spectrum disorder.锂对自闭症谱系障碍儿童和青少年情绪障碍症状的初步研究。
J Child Adolesc Psychopharmacol. 2014 Sep;24(7):399-402. doi: 10.1089/cap.2014.0019. Epub 2014 Aug 5.
4
Does sustained-release lithium reduce impulsive gambling and affective instability versus placebo in pathological gamblers with bipolar spectrum disorders?与安慰剂相比，缓释锂能否减轻双相谱系障碍病理性赌博者的冲动性赌博及情感不稳定症状？
Am J Psychiatry. 2005 Jan;162(1):137-45. doi: 10.1176/appi.ajp.162.1.137.
5
Multiple Antipsychotic Medication Use in Autism Spectrum Disorder.自闭症谱系障碍中多种抗精神病药物的使用
J Child Adolesc Psychopharmacol. 2017 Feb;27(1):91-94. doi: 10.1089/cap.2015.0123. Epub 2015 Oct 14.
6
Lithium treatment moderate-dose use study (LiTMUS) for bipolar disorder: a randomized comparative effectiveness trial of optimized personalized treatment with and without lithium.锂治疗双相障碍的中剂量使用研究（LiTMUS）：一项优化个体化治疗联合和不联合锂的随机对照有效性试验。
Am J Psychiatry. 2013 Jan;170(1):102-10. doi: 10.1176/appi.ajp.2012.12060751.
7
Efficacy of olanzapine in combination with valproate or lithium in the treatment of mania in patients partially nonresponsive to valproate or lithium monotherapy.奥氮平联合丙戊酸盐或锂盐治疗对丙戊酸盐或锂盐单药治疗部分无反应的躁狂症患者的疗效。
Arch Gen Psychiatry. 2002 Jan;59(1):62-9. doi: 10.1001/archpsyc.59.1.62.
8
Mood Stabilizers in Children and Adolescents With Autism Spectrum Disorders.自闭症谱系障碍儿童和青少年的情绪稳定剂
Clin Neuropharmacol. 2015 Sep-Oct;38(5):177-82. doi: 10.1097/WNF.0000000000000096.
9
Does tachyphylaxis occur after repeated antidepressant exposure in patients with Bipolar II major depressive episode?双相II型重度抑郁发作患者反复接触抗抑郁药后是否会出现快速减敏现象？
J Affect Disord. 2009 May;115(1-2):234-40. doi: 10.1016/j.jad.2008.07.007. Epub 2008 Aug 9.
10
Valproate or olanzapine add-on to lithium: an 8-week, randomized, open-label study in Italian patients with a manic relapse.丙戊酸盐或奥氮平联合锂盐治疗：一项针对意大利躁狂复发患者的为期8周的随机开放标签研究。
J Affect Disord. 2007 Apr;99(1-3):247-51. doi: 10.1016/j.jad.2006.09.007. Epub 2006 Oct 23.
引用本文的文献
1
Autism Spectrum Disorder and Epilepsy: Pathogenetic Mechanisms and Therapeutic Implications.自闭症谱系障碍与癫痫：发病机制及治疗意义
J Clin Med. 2025 Apr 2;14(7):2431. doi: 10.3390/jcm14072431.
2
Effects of lithium on mortality and metabolite profiles in Drosophila lithium-inducible SLC6 transporter mutants.锂对果蝇锂诱导型SLC6转运蛋白突变体死亡率和代谢物谱的影响。
Environ Toxicol Pharmacol. 2025 Jun;116:104684. doi: 10.1016/j.etap.2025.104684. Epub 2025 Apr 5.
3
Extended-Release Lithium Treatment for Adolescents with Bipolar Disorder with or Without Comorbid Autism Spectrum Disorder: Protocol of a Longitudinal Prospective Naturalistic Study for the Assessment of Efficacy and Tolerability.用于治疗伴有或不伴有共病自闭症谱系障碍的双相情感障碍青少年的缓释锂盐治疗：一项评估疗效和耐受性的纵向前瞻性自然主义研究方案
J Clin Med. 2024 Oct 17;13(20):6196. doi: 10.3390/jcm13206196.
4
Discordance Between Psychiatric Diagnoses and Medication Use in Children and Adults With Autism Presenting in Crisis.自闭症儿童和成人在危机状态下精神科诊断与用药情况的不一致
Focus (Am Psychiatr Publ). 2024 Apr;22(2):150-161. doi: 10.1176/appi.focus.20230027. Epub 2024 Apr 10.
5
Disrupted extracellular matrix and cell cycle genes in autism-associated Shank3 deficiency are targeted by lithium.自闭症相关 Shank3 缺乏症中外细胞基质和细胞周期基因的紊乱受锂的靶向调控。
Mol Psychiatry. 2024 Mar;29(3):704-717. doi: 10.1038/s41380-023-02362-y. Epub 2023 Dec 20.
6
Diet in treatment of autism spectrum disorders.饮食在自闭症谱系障碍治疗中的应用
Front Neurosci. 2023 Jul 10;16:1031016. doi: 10.3389/fnins.2022.1031016. eCollection 2022.
7
Comorbidities in Youth with Bipolar Disorder: Clinical Features and Pharmacological Management.青少年双相障碍共病：临床特征与药物治疗管理。
Curr Neuropharmacol. 2023;21(4):911-934. doi: 10.2174/1570159X20666220706104117.
8
Glycogen Synthase Kinase-3 Inhibitors: Preclinical and Clinical Focus on CNS-A Decade Onward.糖原合酶激酶-3抑制剂：十年以来中枢神经系统的临床前和临床研究重点
Front Mol Neurosci. 2022 Jan 21;14:792364. doi: 10.3389/fnmol.2021.792364. eCollection 2021.
9
A Pilot Study on Early-Onset Schizophrenia Reveals the Implication of Wnt, Cadherin and Cholecystokinin Receptor Signaling in Its Pathophysiology.一项关于早发性精神分裂症的初步研究揭示了Wnt、钙黏蛋白和胆囊收缩素受体信号通路在其病理生理学中的作用。
Front Genet. 2021 Dec 17;12:792218. doi: 10.3389/fgene.2021.792218. eCollection 2021.
10
Decades of Progress in the Psychopharmacology of Autism Spectrum Disorder.自闭症谱系障碍精神药理学的几十年进展。
J Autism Dev Disord. 2021 Dec;51(12):4370-4394. doi: 10.1007/s10803-021-05237-9. Epub 2021 Sep 7.
本文引用的文献
1
Probing the lithium-response pathway in hiPSCs implicates the phosphoregulatory set-point for a cytoskeletal modulator in bipolar pathogenesis.在 hiPSCs 中探测锂反应途径表明在双相发病机制中细胞骨架调节剂的磷酸化调节设定点。
Proc Natl Acad Sci U S A. 2017 May 30;114(22):E4462-E4471. doi: 10.1073/pnas.1700111114. Epub 2017 May 12.
2
Use of psychotropic drugs in patients with autism spectrum disorders: a systematic review.自闭症谱系障碍患者使用精神药物：一项系统综述。
Acta Psychiatr Scand. 2017 Jan;135(1):8-28. doi: 10.1111/acps.12644. Epub 2016 Sep 13.
3
Molecular targets of lithium action.锂作用的分子靶点。
Acta Neuropsychiatr. 2003 Dec;15(6):316-40. doi: 10.1046/j.1601-5215.2003.00049.x.
4
Lithium as a rescue therapy for regression and catatonia features in two SHANK3 patients with autism spectrum disorder: case reports.锂盐作为两名患有自闭症谱系障碍的SHANK3患者退缩和紧张症特征的抢救疗法：病例报告
BMC Psychiatry. 2015 May 7;15:107. doi: 10.1186/s12888-015-0490-1.
5
Preliminary investigation of lithium for mood disorder symptoms in children and adolescents with autism spectrum disorder.锂对自闭症谱系障碍儿童和青少年情绪障碍症状的初步研究。
J Child Adolesc Psychopharmacol. 2014 Sep;24(7):399-402. doi: 10.1089/cap.2014.0019. Epub 2014 Aug 5.
6
Lithium: the pharmacodynamic actions of the amazing ion.锂：神奇离子的药效作用。
Ther Adv Psychopharmacol. 2013 Jun;3(3):163-76. doi: 10.1177/2045125312471963.
7
Managing irritability and aggression in autism spectrum disorders in children and adolescents.应对儿童和青少年自闭症谱系障碍中的易怒和攻击行为。
Dev Disabil Res Rev. 2010;16(3):258-64. doi: 10.1002/ddrr.118.
8
The history of lithium therapy.锂疗法的历史。
Bipolar Disord. 2009 Jun;11 Suppl 2(Suppl 2):4-9. doi: 10.1111/j.1399-5618.2009.00706.x.
9
What is the optimal serum lithium level in the long-term treatment of bipolar disorder--a review?双相情感障碍长期治疗中血清锂的最佳水平是多少——一篇综述？
Bipolar Disord. 2008 Mar;10(2):231-7. doi: 10.1111/j.1399-5618.2007.00475.x.
10
Lithium treatment reduces suicide risk in recurrent major depressive disorder.锂盐治疗可降低复发性重度抑郁症的自杀风险。
J Clin Psychiatry. 2007 Mar;68(3):380-3. doi: 10.4088/jcp.v68n0304.
Zotero 插件