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儿童和青少年自闭症谱系障碍核心症状及共病的药物治疗:一项系统评价

Pharmacological Management of Core Symptoms and Comorbidities of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review.

作者信息

Maniram Jennal, Karrim Saira B S, Oosthuizen Frasia, Wiafe Ebenezer

机构信息

School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

Clinical Pharmacy Services Unit, Directorate of Pharmacy, Ho Teaching Hospital, Ho, Ghana.

出版信息

Neuropsychiatr Dis Treat. 2022 Aug 7;18:1629-1644. doi: 10.2147/NDT.S371013. eCollection 2022.

Abstract

PURPOSE

The pharmacological management of Autism Spectrum Disorder (ASD) in children remains a challenge due to limited effective management options and the absence of approved drugs to manage the core symptoms. This review aims to describe and highlight effective pharmacological management options employed in managing the core symptoms and comorbidities of ASD from eligible studies over the past decade.

METHODS

A search of databases; PubMed, Scopus, Science Direct, and PsychInfo for pharmacotherapeutic options for ASD was conducted in this systematic review. Duplicate studies were removed by utilizing the EndNote citation manager. The studies were subsequently screened independently by two authors. Eligible studies from 01 January 2012 to 01 January 2022 were included based on established eligibility criteria. A narrative synthesis was used for data analysis.

RESULTS

The systematic review provides a comprehensive list of effective management options for ASD comorbidities and core symptoms from 33 included studies. The management options for ASD comorbidities; insomnia, hyperactivity, irritability and aggression, gastrointestinal disturbances, and subclinical epileptiform discharges, were reviewed. Risperidone, aripiprazole, methylphenidate, guanfacine, levetiracetam, and atomoxetine are examples of effective pharmacological drugs against ASD comorbidities. Additionally, this review identified various drugs that improve the core symptoms of ASD and include but are not limited to, bumetanide, buspirone, intranasal oxytocin, intranasal vasopressin, and prednisolone.

CONCLUSION

This review has successfully summarized the pharmacological advancements made in the past decade to manage ASD. Although there is still no pharmacological cure for ASD core symptoms or additional drugs that have obtained regulatory approval for use in ASD, the availability of promising pharmacological agents are under evaluation and study.

摘要

目的

由于有效的管理选择有限且缺乏用于管理核心症状的获批药物,儿童自闭症谱系障碍(ASD)的药物治疗仍然是一项挑战。本综述旨在描述和强调过去十年中符合条件的研究中用于管理ASD核心症状和共病的有效药物治疗选择。

方法

在本系统综述中,对数据库PubMed、Scopus、Science Direct和PsychInfo进行了关于ASD药物治疗选择的检索。利用EndNote引文管理器去除重复研究。随后由两位作者独立筛选研究。根据既定的纳入标准,纳入了2012年1月1日至2022年1月1日的符合条件的研究。采用叙述性综合分析法进行数据分析。

结果

该系统综述提供了一份来自33项纳入研究的ASD共病和核心症状有效管理选择的综合清单。对ASD共病的管理选择进行了综述,包括失眠、多动、易怒和攻击行为、胃肠道紊乱以及亚临床癫痫样放电。利培酮、阿立哌唑、哌甲酯、胍法辛、左乙拉西坦和托莫西汀是治疗ASD共病的有效药物实例。此外,本综述还确定了各种可改善ASD核心症状的药物,包括但不限于布美他尼、丁螺环酮、鼻内催产素、鼻内加压素和泼尼松龙。

结论

本综述成功总结了过去十年中在ASD治疗方面取得的药理学进展。尽管目前仍没有药物可以治愈ASD的核心症状,也没有其他药物获得用于ASD的监管批准,但有前景的药物制剂的可用性正在评估和研究中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91dd/9371468/10c068b70139/NDT-18-1629-g0001.jpg

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