Alsayouf Hamza A, Talo Haitham, Biddappa Marisa L, De Los Reyes Emily
Kids Neuro Clinic and Rehab Center, Dubai Healthcare City, Al Razi Medical Complex, Dubai 1015, United Arab Emirates.
Pediatric Neurology, Nationwide Children's Hospital, Ohio State University, Columbus, OH 43210, USA.
Children (Basel). 2021 Apr 22;8(5):318. doi: 10.3390/children8050318.
Risperidone and aripiprazole are approved by the USA Food and Drug Administration for the treatment of irritability and aggression in children from the ages of 5 and 6 years, respectively. However, there are no approved medications for the treatment of autism spectrum disorder (ASD) core signs and symptoms. Nevertheless, early intervention is recognized as key to improving long-term outcomes. This retrospective case study included 10 children (mean age, 2 years 10 months) with ASD who presented with persistent irritability and aggression before 4 years of age that was unresponsive to behavioral interventions and sufficiently severe to consider pharmacological intervention with risperidone or aripiprazole combined with standard supportive therapies. Besides ameliorating comorbid behaviors, improvement was observed in ASD core signs and symptoms for all patients, with minimal-to-no symptoms observed in 60% of patients according to the Childhood Autism Rating Scale 2-Standard Test and Clinical Global Impression scales. Excessive weight gain in two patients was the only adverse effect observed that required intervention. This is the first study to suggest that ASD can potentially be treated in very young children (<4 years). Clinical trials are urgently required to validate these findings among this pediatric population.
利培酮和阿立哌唑分别被美国食品药品监督管理局批准用于治疗5岁和6岁儿童的易激惹和攻击行为。然而，目前尚无获批用于治疗自闭症谱系障碍（ASD）核心症状的药物。尽管如此，早期干预被认为是改善长期预后的关键。这项回顾性病例研究纳入了10名ASD儿童（平均年龄2岁10个月），这些儿童在4岁之前出现持续的易激惹和攻击行为，对行为干预无反应，且严重程度足以考虑使用利培酮或阿立哌唑联合标准支持性疗法进行药物干预。除了改善共病行为外，所有患者的ASD核心症状均有改善，根据儿童自闭症评定量表2标准测试和临床总体印象量表，60%的患者症状轻微或无症状。观察到的唯一需要干预的不良反应是两名患者体重过度增加。这是第一项表明ASD在幼儿（<4岁）中可能得到治疗的研究。迫切需要进行临床试验以在这一儿科人群中验证这些发现。
