The Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, 55 Fruit Street, WRN 626, Boston, MA 02114, USA; Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston MA, USA; Department of Psychiatry, Harvard Medical School, Boston MA, USA.
Clinical and Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston MA, USA; Department of Psychiatry, Harvard Medical School, Boston MA, USA.
Child Adolesc Psychiatr Clin N Am. 2022 Jul;31(3):449-468. doi: 10.1016/j.chc.2022.03.012. Epub 2022 May 11.
Attention-deficit/hyperactivity disorder (ADHD) is the most frequent comorbid disorder that is observed at a higher rate and with greater morbidity in higher intellectually functioning populations with autism. Up to 85% of the populations with autism and 15% of individuals with ADHD suffer from a reciprocal comorbidity that is highly under-recognized in intellectually capable populations. Limited empirical evidence is available on the response of anti-ADHD agents in autism populations with ADHD. In autism spectrum disorder (ASD) populations, response to methylphenidate for the treatment of hyperactivity is worse than typically expected in the presence of the intellectual disability. The anti-ADHD response to atomoxetine in autism populations is worse than typically expected although tolerability is similar to that observed in the typicals. The hyperactivity response to guanfacine treatment in predominantly intellectually impaired populations with ASD is as robust as observed in the typicals although tolerability was worse than typically expected. Further trials are warranted to document the extent of atypical anti-ADHD response in intellectually capable populations with autism.
注意缺陷多动障碍（ADHD）是最常见的合并症，在高智商人群中，自闭症的发病率更高，发病率更高。高达 85%的自闭症患者和 15%的 ADHD 患者患有相互并存的疾病，而在高智商人群中，这种疾病的认知度非常低。关于 ADHD 人群中抗 ADHD 药物的反应，目前只有有限的实证证据。在自闭症谱系障碍（ASD）人群中，治疗多动的利他林的反应比智力障碍患者的预期要差。自闭症人群中阿托西汀的抗 ADHD 反应比预期的要差，尽管耐受性与典型人群相似。在以智力受损为主的 ASD 人群中，胍法辛治疗多动的反应与典型人群一样明显，但耐受性比预期的要差。需要进一步的试验来记录自闭症高智商人群中非典型抗 ADHD 反应的程度。
