Ritfeld Gaby J, Kable Julie A, Holton Jennifer E, Coles Claire D
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive NE, Suite 200, Atlanta, GA, USA.
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Child Psychiatry Hum Dev. 2022 Apr;53(2):268-277. doi: 10.1007/s10578-021-01124-7. Epub 2021 Jan 27.
Psychiatric symptoms in children with Fetal Alcohol Spectrum Disorders (FASD) present with high prevalence and morbidity, often across symptom domains, e.g. ADHD-like symptoms, emotional dysregulation and sleep problems. Polypharmacy is often used, but no empirically-based guidelines exist regarding optimal treatment for these children. Moreover, stimulant use in these children is controversial as their responsiveness may be different due to altered neural circuitry associated with prenatal alcohol exposure. The objective of this review is to give an overview of existing data on pharmacological treatments of neurobehavioral symptoms in FASD. Our literature review yielded limited and conflicting clinical data on the effectiveness of pharmacological treatments for psychiatric symptoms in children with FASD, with some symptom domains lacking data altogether. We emphasize the need for clinical trials to guide pharmacological treatments in this complex population.
胎儿酒精谱系障碍(FASD)患儿的精神症状具有高患病率和高发病率,通常涉及多个症状领域,例如注意力缺陷多动障碍(ADHD)样症状、情绪调节障碍和睡眠问题。常采用联合用药,但对于这些患儿的最佳治疗方案,尚无基于实证的指南。此外,在这些患儿中使用兴奋剂存在争议,因为与产前酒精暴露相关的神经回路改变可能导致他们的反应性有所不同。本综述的目的是概述FASD神经行为症状药物治疗的现有数据。我们的文献综述发现,关于FASD患儿精神症状药物治疗有效性的临床数据有限且相互矛盾,有些症状领域完全缺乏数据。我们强调需要进行临床试验,以指导这一复杂人群的药物治疗。