Aishworiya Ramkumar, Valica Tatiana, Hagerman Randi, Restrepo Bibiana
Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA (Aishworiya, Valica, Hagerman, Restrepo); Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore (Aishworiya); Association for Children With Autism, Chisinau, Moldova (Valica); Department of Pediatrics, University of California Davis School of Medicine, 4610 X St, Sacramento, CA 95817, USA (Hagerman, Restrepo).
Focus (Am Psychiatr Publ). 2024 Apr;22(2):198-211. doi: 10.1176/appi.focus.24022006. Epub 2024 Apr 10.
While behavioral interventions remain the mainstay of treatment of autism spectrum disorder (ASD), several potential targeted treatments addressing the underlying neurophysiology of ASD have emerged in the last few years. These are promising for the potential to, in future, become part of the mainstay treatment in addressing the core symptoms of ASD. Although it is likely that the development of future targeted treatments will be influenced by the underlying heterogeneity in etiology, associated genetic mechanisms influencing ASD are likely to be the first targets of treatments and even gene therapy in the future for ASD. In this article, we provide a review of current psychopharmacological treatment in ASD including those used to address common comorbidities of the condition and upcoming new targeted approaches in autism management. Medications including metformin, arbaclofen, cannabidiol, oxytocin, bumetanide, lovastatin, trofinetide, and dietary supplements including sulforophane and N-acetylcysteine are discussed. Commonly used medications to address the comorbidities associated with ASD including atypical antipsychotics, serotoninergic agents, alpha-2 agonists, and stimulant medications are also reviewed. Targeted treatments in Fragile X syndrome (FXS), the most common genetic disorder leading to ASD, provide a model for new treatments that may be helpful for other forms of ASD. Appeared originally in 2022; 19:248-262.
虽然行为干预仍然是自闭症谱系障碍(ASD)治疗的主要手段,但在过去几年中,已经出现了几种针对ASD潜在神经生理学的靶向治疗方法。这些方法有望在未来成为解决ASD核心症状的主要治疗手段的一部分。尽管未来靶向治疗的发展可能会受到病因潜在异质性的影响,但影响ASD的相关遗传机制可能是未来ASD治疗甚至基因治疗的首要靶点。在本文中,我们综述了ASD目前的心理药物治疗,包括用于解决该病症常见共病的药物,以及自闭症管理中即将出现的新靶向方法。讨论了包括二甲双胍、阿巴氯芬、大麻二酚、催产素、布美他尼、洛伐他汀、曲非尼肽等药物,以及包括萝卜硫素和N-乙酰半胱氨酸在内的膳食补充剂。还综述了用于解决与ASD相关共病的常用药物,包括非典型抗精神病药物、5-羟色胺能药物、α-2激动剂和兴奋性药物。脆性X综合征(FXS)是导致ASD最常见的遗传疾病,其靶向治疗为可能有助于其他形式ASD的新治疗方法提供了一个模型。最初发表于2022年;19:248 - 262。