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氯丙嗪停药后刻板行为的变化:多种药物联用对反应类别归属的影响

Changes in Stereotypical Behavior Following Chlorpromazine Termination: Polypharmcy Effects on Response Class Membership.

作者信息

Valdovinos Maria G, Aguilar Marisela, Piersma Drew, Wilkinson Alyssa, Kennedy Craig H

机构信息

Drake University.

University of Connecticut.

出版信息

Adv Neurodev Disord. 2020 Sep;4(3):247-252. doi: 10.1007/s41252-020-00158-7. Epub 2020 May 20.

DOI:10.1007/s41252-020-00158-7
PMID:33738335
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7962922/
Abstract

OBJECTIVES

A paucity of information exists relating to the possible biological and environmental interactions influencing the occurrence of stereotypical behavior. In particular, there is limited research on the effects of psychotropic medication use on stereotypy presentation in individuals diagnosed with developmental disabilities such as intellectual disability and autism spectrum disorder.

METHODS

We studied the stereotypy of a man with autism spectrum disorder and intellectual disability across 2 years. The topographies of stereotypical behavior included walking in circles, head tapping, arm flinging, and object stereotypy. These behaviors were observed weekly while the participant received daily dosages of 25 mg of chlorpromazine, 1.5 mg of lorazepam, and 2,500 mg of divalproex. At Week 75, chlorpromazine was discontinued while the other drugs and dosages were maintained.

RESULTS

We observed a statistically significant decrease in walking in circles, but no changes in the other topographies of stereotypy.

CONCLUSIONS

The results suggest that the gross motor activity was differentially affected by the chlorpromazine discontinuation and also suggests that alterations in dopamine receptor binding may have selectively influenced changes in stereotypical responding.

摘要

目的

关于可能影响刻板行为发生的生物和环境相互作用的信息匮乏。特别是,对于使用精神药物对被诊断患有发育障碍(如智力残疾和自闭症谱系障碍)的个体刻板行为表现的影响,研究有限。

方法

我们对一名患有自闭症谱系障碍和智力残疾的男性的刻板行为进行了为期两年的研究。刻板行为的表现形式包括转圈行走、轻拍头部、挥舞手臂和物体刻板行为。在参与者每日服用25毫克氯丙嗪、1.5毫克劳拉西泮和2500毫克丙戊酸的期间,每周观察这些行为。在第75周时,停用氯丙嗪,同时维持其他药物及其剂量。

结果

我们观察到转圈行走的行为在统计学上有显著减少,但其他刻板行为表现形式没有变化。

结论

结果表明,氯丙嗪的停用对大肌肉活动有不同影响,也表明多巴胺受体结合的改变可能选择性地影响了刻板反应的变化。

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本文引用的文献

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Prevalence and determinants of motor stereotypies in autism spectrum disorder: A systematic review and meta-analysis.自闭症谱系障碍中运动刻板行为的流行率及决定因素:系统评价和荟萃分析。
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