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儿童和青少年孤独症谱系障碍相关行为障碍的药物治疗新进展。

Recent Advances in the Pharmacological Management of Behavioral Disturbances Associated with Autism Spectrum Disorder in Children and Adolescents.

机构信息

Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.

出版信息

Paediatr Drugs. 2020 Oct;22(5):473-483. doi: 10.1007/s40272-020-00408-0.

Abstract

Autism spectrum disorder (ASD) is a heterogeneous neuropsychiatric condition affecting an estimated one in 36 children. Youth with ASD may have severe behavioral disturbances including irritability, aggression, and hyperactivity. Currently, there are only two medications (risperidone and aripiprazole) approved by the US Food and Drug Administration (FDA) for the treatment of irritability associated with ASD. Pharmacologic treatments are commonly used to target ASD-associated symptoms including irritability, mood lability, anxiety, and hyperactivity. However, evidence for the efficacy of many commonly used treatments is limited by the lack of large placebo-controlled trials of these medications in this population. Research into the pathophysiology of ASD has led to new targets for pharmacologic therapy including the neuroimmune system, the endocannabinoid system, and the glutamatergic neurotransmitter system. The goal of this review is to provide an overview of the current evidence base for commonly used treatments, as well as emerging treatment options for common behavioral disturbances seen in youth with ASD.

摘要

自闭症谱系障碍(ASD)是一种异质性神经精神疾病,估计每 36 名儿童中就有 1 名受到影响。患有 ASD 的青少年可能会出现严重的行为障碍,包括易怒、攻击性和多动。目前,仅有两种药物(利培酮和阿立哌唑)获得美国食品和药物管理局(FDA)批准用于治疗与 ASD 相关的易激惹。药物治疗常用于针对 ASD 相关症状,包括易怒、情绪波动、焦虑和多动。然而,由于缺乏这些药物在该人群中进行的大型安慰剂对照试验,许多常用治疗方法的疗效证据有限。对 ASD 病理生理学的研究为药物治疗提供了新的靶点,包括神经免疫系统、内源性大麻素系统和谷氨酸能神经递质系统。本综述的目的是概述常用于治疗 ASD 的常见治疗方法的现有证据基础,以及用于治疗 ASD 青少年常见行为障碍的新兴治疗选择。

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