自闭症谱系障碍的精神药物治疗最新进展。

Focus (American Psychiatric Publishing) Pub Date : 2024-04-01 Epub Date: 2024-04-10 DOI:10.1176/appi.focus.24022006
Ramkumar Aishworiya, Tatiana Valica, Randi Hagerman, Bibiana Restrepo
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引用次数: 0

摘要

虽然行为干预仍是治疗自闭症谱系障碍(ASD)的主要方法,但在过去几年中,出现了几种针对自闭症谱系障碍潜在神经生理学的潜在靶向治疗方法。这些疗法有望在未来成为治疗自闭症核心症状的主流疗法。虽然未来靶向治疗的发展很可能会受到病因异质性的影响,但影响 ASD 的相关遗传机制很可能会成为 ASD 治疗甚至基因治疗的首选目标。在这篇文章中,我们回顾了目前针对 ASD 的精神药物治疗,包括用于治疗 ASD 常见并发症的药物,以及即将推出的自闭症治疗新靶向方法。文章讨论的药物包括二甲双胍、阿巴曲芬、大麻二酚、催产素、布美他尼、洛伐他汀、特罗芬肽,以及舒洛芬和 N-乙酰半胱氨酸等膳食补充剂。此外,还综述了治疗 ASD 相关合并症的常用药物,包括非典型抗精神病药物、5-羟色胺能药物、α-2 促效剂和兴奋剂药物。脆性 X 综合征(FXS)是导致 ASD 的最常见遗传性疾病,它的靶向治疗为可能有助于其他形式 ASD 的新疗法提供了范例。最初发表于《神经治疗学》2022; 19:248-262。
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An Update on Psychopharmacological Treatment of Autism Spectrum Disorder.

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 Neurotherapeutics 2022; 19:248-262.

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