Попередня Наступна

ПОТОЧНИЙ НОМЕР

№4' 2020p.

ПСИХІАТРІЯ
DOI (https://doi.org/10.37436/2308-5274-2020-4-9)

ФАРМАКОЛОГІЧНЕ ЛІКУВАННЯ РОЗЛАДІВ АУТИСТИЧНОГО СПЕКТРА: НАПРЯМКИ ТА ПЕРСПЕКТИВИ

Доц. Л. А. БОДНАР
Українська медична стоматологічна академія, Полтава, Україна

Подано огляд сучасної літератури про психофармакологічні засоби, що застосовуються при лікуванні розладів аутистичного спектра та коморбідних станів. Фармакологічне лікування включає атипові антипсихотики, антидепресанти, психостимулятори та агоністи альфа−2 адренергічних рецепторів, які частково полегшують основні симптоми аутистичного розладу або усувають прояви супровідних захворювань.

Ключові слова: розлади аутистичного спектра, коморбідні стани, лікування.

ФАРМАКОЛОГИЧЕСКОЕ ЛЕЧЕНИЕ РАССТРОЙСТВ АУТИСТИЧЕСКОГО СПЕКТРА: НАПРАВЛЕНИЯ И ПЕРСПЕКТИВЫ

Л. А. БОДНАР

Представлен обзор современной литературы о психофармакологических средствах, применяемых при лечении расстройств аутистического спектра и коморбидных состояний. Фармакологическое лечение включает атипичные антипсихотики, антидепрессанты, психостимуляторы и агонисты альфа−2 адренергических рецепторов, которые частично облегчают основные симптомы аутистического расстройства или устраняют проявления сопутствующих заболеваний.

Ключевые слова: расстройства аутистического спектра, коморбидные состояния, лечение.

PHARMACOLOGICAL TREATMENT OF AUTISM SPECTRUM DISORDERS: DIRECTIONS AND PROSPECTS

L. A. BODNAR

A review of the modern published reports on psychopharmacological drugs used in the treatment of autism spectrum disorders and comorbid conditions has been presented. Pharmacological treatment includes atypical antipsychotics, antidepressants, psychostimulants and alpha−2 adrenergic receptor agonists, which partially alleviate the main symptoms of autism or eliminate the manifestations of concomitant diseases.

Key words: autism spectrum disorders, comorbid conditions, treatment.




REFERENCES


1. E. Stepanova, S. Dowling, M. Phelps, R. L. Findling Dialogues Clin. Neurosci. 2017. Vol. 19 (4). P. 395−402.

2. Martsenkovs'kii І. A., Martsenkovs'ka І. І. Rozladi autistichnogo spektra: faktori riziku, osoblivostі dіagnostiki i terapії // Mіzhnarodnii nevrologіchnii zhurn. 2018. № 4 (98). doi: http://dx.doi.org/10.22141/2224−0713.4.98.2018.139429

3. Levy S. E., Hyman S. L. Complementary and alternative medicine treatments for children with autism spectrum disorders // Child. Adolesc. Psychiatr. Clin. N. Am. 2015. № 24 (1). R. 117−143.

4. Risperidone dosing in children and adolescents with autistic disorder: a double−blind, placebo−controlled study / J. M. Kent et al. // J. Autism Dev. Disord. 2013. № 43 (8). R. 1773−1783. doi: https://doi.org/10.1007/s10803−012−1723−5

5. Initial severity and efficacy of risperidone in autism: results from the RUPP trial / S. Z. Levine et al. // Eur. Psychiatry. 2016. № 32. R. 16−20. doi: https://doi.org/10.1016/j.eurpsy.2015.11.004

6. Research Units on Pediatric Psychopharmacology Autism Network. Risperidone treatment of autistic disorder: longer−term benefits and blinded discontinuation after 6 months // Am. J. Psychiatry. 2005. № 162 (7). R. 1361−1369. doi: https://doi.org/10.1176/appi.ajp.162.7.1361

7. Tolerability, safety, and benefits of risperidone in children and adolescents with autism: 21−month follow−up after 8−week placebo−controlled trial / M. Aman et al. // J. Child. Adolesc. Psychopharmacol. 2015. № 25 (6). R. 482−493. doi: https://doi.org/10.1089/cap.2015.0005

8. Effect of aripiprazole 2 to 15 mg/d on health−related quality of life in the treatment of irritability associated with autistic disorder in children: a post hoc analysis of two controlled trials / J. W. Varni et al. // Clin. Ther. 2012. № 34 (4). R. 980−992. doi: https://doi.org/10.1016/j.clinthera.2012.02.023

9. A randomized controlled trial investigating the safety and efficacy of aripiprazole in the long−term maintenance treatment of pediatric patients with irritability associated with autistic disorder / R. L. Findling et al. // J. Clin. Psychiatry. 2014. № 75 (1). R. 22−30. doi: https://doi.org/10.4088/jcp.13m08500

10. Aripiprazole in the treatment of irritability in pediatric patients (aged 6−17 years) with autistic disorder: results from a 52−week, open−label study / R. N. Marcus et al. // J. Child. Adolesc. Psychopharmacol. 2011. № 21 (3). R. 229−236. doi: https://doi.org/10.1089/cap.2009.0121

11. Aripiprazole treatment of irritability associated with autistic disorder and the relationship between prior antipsychotic exposure, adverse events, and weight change / R. Mankoski et al. // J. Child. Adolesc. Psychopharmacol. 2013. № 23 (8). R. 572−576. doi: https://doi.org/10.1089/cap.2012.0075

12. Ghanizadeh A., Sahraeizadeh A., Berk M. A head−to−head comparison of aripiprazole and risperidone for safety and treating autistic disorders, a randomized double blind clinical trial // Child. Psychiatry Hum. Dev. 2014. № 45 (2). R. 185−192. doi: https://doi.org/10.1007/s10578−013−0390−x

13. Body mass index change in autism spectrum disorders: comparison of treatment with risperidone and aripiprazole / L. K. Wink et al. // J. Child. Adolesc. Psychopharmacol. 2014. № 24 (2). R. 78−82. doi: https://doi.org/10.1089/cap.2013.0099

14. Open−label study of olanzapine in children with pervasive developmental disorder / C. Kernner et al. // J. Clin. Psychopharmacol. 2002. Vol. 22 (5). P. 455−460.

15. A double−blind placebo−controlled pilot study of olanzapine in childhood/adolescent pervasive developmental disorder / E. Hollander et al. // J. Child. Adolesc. Psychopharmacol. 2006. Vol. 16 (5). P. 541−548. doi: https://doi.org/10.1089/cap.2006.16.541

16. Olanzapine versus haloperidol in children with autistic disorder: an open pilot study / R. P. Malone et al. // J. Am. Acad. Child. Adolesc. Psychiatry. 2001. Vol. 40 (8). P. 887−894. doi: https://doi.org/10.1097/00004583−200108000−00009

17. Paliperidone for irritability in adolescents and young adults with autistic disorder / K. A. Stigler et al. // Psychopharmacology (Berl.). 2012. Vol. 223 (2). P. 237−245. doi: https://doi.org/10.1007/s00213−012−2711−3

18. Open−label quetiapine in the treatment of children and adolescents with autistic disorder / A. Martin, K. Koenig, L. Scahill, J. Bregman // J. Child. Adolesc. Psychopharmacol. 1999. Vol. 9 (2). P. 99−107. doi: https://doi.org/10.1007/s00213−012−2711−3

19. Quetiapine in nine youths with autistic disorder / R. L. Findling et al. // J. Child. Adolesc. Psychopharmacol. 2004. Vol. 14 (2). P. 287−294.

20. Golubchik P., Sever J., Weizman A. Low−dose quetiapine for adolescents with autistic spectrum disorder and aggressive behavior: open−label trial // Clin. Neuropharmacol. 2011. Vol. 34 (6). P. 216−219. doi: https://doi.org/10.1097/wnf.0b013e31823349ac

21. A Retrospective naturalistic study of ziprasidone for irritability in youth with autism spectrum disorder / K. Dominick, L. K. Wink, C. J. McDougle, C. A. Erickson // J. Child. Adolesc. Psychopharmacol. 2015. Vol. 25 (5). P. 397−401. doi: https://doi.org/10.1089/cap.2014.0111

22. Ziprasidone in adolescents with autism: an open−label pilot study / R. P. Malone, M. A. Delaney, S. B. Hyman, J. R. Cater // J. Child. Adolesc. Psychopharmacol. 2007. Vol. 17 (6). P. 779−790. doi: https://doi.org/10.1089/cap.2006.0126

23. Lurasidone for the treatment of irritability associated with autistic disorder / A. Loebel et al. // J. Autism Dev. Disord. 2016. Vol. 46 (4). P. 1153−1163. doi: https://doi.org/10.1007/s10803−015−2628−x

24. Divalproex sodium vs placebo for the treatment of irritability in children and adolescents with autism spectrum disorders / E. Hollander et al. // Neuropsychopharmacology. 2010. Vol. 35 (4). P. 990−998. doi: https://doi.org/10.1038/npp.2009.202

25. A double−blind, placebo−controlled study of valproate for aggression in youth with pervasive developmental disorders / J. A. Hellings et al. // J. Child. Adolesc. Psychopharmacol. 2005. Vol. 15 (4). P. 682−692.

26. Rugino T. A., Samsock T. C. Levetiracetam in autistic children: an open−label study // J. Dev. Behav. Pediatr. 2002. Vol. 23 (4). P. 225−230. doi: https://doi.org/10.1097/00004703−200208000−00006

27. Levetiracetam versus placebo in childhood and adolescent autism: a double−blind placebo−controlled study / S. Wasserman et al. // Int. Clin. Psychopharmacol. 2006. Vol. 21 (6). P. 363−367. doi: https://doi.org/10.1097/01.yic.0000224787.13782.0f

28. Mazzone L., Ruta L. Topiramate in children with autistic spectrum disorders // Brain Dev. 2006. Vol. 28 (10). P. 668. doi: https://doi.org/10.1016/j.braindev.2006.05.004

29. Double−blind, placebo−controlled trial of risperidone plus topiramate in children with autistic disorder / V. Rezaei et al. // Prog. Neuropsychopharmacol. Biol. Psychiatry. 2010. Vol. 34 (7). P. 1269−1272. doi: https://doi.org/10.1016/j.pnpbp.2010.07.005

30. Lamotrigine therapy for autistic disorder: a randomized, double−blind, placebo−controlled trial / K. M. Belsito et al. // J. Autism Dev. Disord. 2001. Vol. 31 (2). P. 175−181.

31. Preliminary investigation of lithium for mood disorder symptoms in children and adolescents with autism spectrum disorder / M. Siegel et al. // J. Child. Adolesc. Psychopharmacol. 2014. Vol. 24 (7). P. 399−402. doi: https://doi.org/10.1089/cap.2014.0019

32. Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism / B. H. King et al. // Arch. Gen. Psychiatry. 2009. Vol. 66 (6). P. 583−590. doi: https://doi.org/10.3410/f.1162045.622501

33. Autism Speaks announces results reported for the study of fluoxetine in autism (SOFIA) [Autism Speaks press release]. URL: http://www.autismspeaks.org/about−us/press−releases/autism−speaks−announces−results−reportedstudy−fluoxetine−autism−sofia. Published Feb 18, 2009. Accessed October 2017. doi: https://doi.org/10.1002/aur.10

34. Low−dose fluvoxamine treatment of children and adolescents with pervasive developmental disorders: a prospective, open−label study / A. Martin, K. Koenig, G. M. Anderson, L. Scahill // J. Autism Dev. Disord. 2003. Vol. 33 (1). P. 77−85.

35. Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD) / K. Williams et al. // Cochrane Database Syst. Rev. 2013. Vol. 8. CD004677. doi: https://doi.org/10.1002/14651858.cd004677.pub2

36. Effects of extended release methylphenidate treatment on ratings of attention−deficit/hyperactivity disorder (ADHD) and associated behavior in children with autism spectrum disorders and ADHD symptoms / D. A. Pearson et al. // J. Child. Adolesc. Psychopharmacol. 2013. Vol. 23 (5). P. 337−351. doi: https://doi.org/10.1089/cap.2012.0096

37. Positive effects of methylphenidate on social communication and self−regulation in children with pervasive developmental disorders and hyperactivity / L. B. Jahromi et al. // J. Autism Dev. Disord. 2009. Vol. 39 (3). P. 395−404. doi: https://doi.org/10.1007/s10803−008−0636−9

38. Dose−response effects of long−acting liquid methylphenidate in children with attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD): a pilot study / S. J. Kim et al. // J. Autism Dev. Disord. 2017. Vol. 47 (8). P. 2307−2313. doi: https://doi.org/10.1007/s10803−017−3125−1

39. Extended−release guanfacine for hyperactivity in children with autism spectrum disorder / L. Scahill et al. // Am. J. Psychiatry. 2015. Vol. 172 (12). P. 1197−1206.

40. Possible influence of variant of the P−glycoprotein gene (MDR1/ABCB1) on clinical response to guanfacine in children with pervasive developmental disorders and hyperactivity / J. T. McCracken et al. // J. Child. Adolesc. Psychopharmacol. 2010. Vol. 20 (1). P. 1−5. doi: https://doi.org/10.1089/cap.2009.0059

41. Use of clonidine in children with autism spectrum disorders / X. Ming, E. Gordon, N. Kang, G. C. Wagner // Brain Dev. 2008. Vol. 30 (7). P. 454−460. doi: https://doi.org/10.1016/j.braindev.2007.12.007

42. Atomoxetine, parent training, and their combination in children with autism spectrum disorder and attention−deficit/hyperactivity disorder / B. L. Handen et al. // J. Am. Acad. Child. Adolesc. Psychiatry. 2015. Vol. 54 (11). P. 905−915. doi: https://doi.org/10.1016/j.jaac.2015.08.013

43. Atomoxetine and parent training for children with autism and attention−deficit/hyperactivity disorder: a 24−week extension study / T. Smith et al. // Am. Acad. Child. Adolesc. Psychiatry. 2016. Vol. 55 (10). P. 868−876.e2. doi: https://doi.org/10.1016/j.jaac.2016.06.015

44. Nasal oxytocin for social deficits in childhood autism: a randomized controlled trial / M. R. Dadds et al. // J. Autism Dev. Disord. 2014. Vol. 44 (3). P. 521−531. doi: https://doi.org/10.1007/s10803−013−1899−3

45. The effects of a course of intranasal oxytocin on social behaviors in youth diagnosed with autism spectrum disorders: a randomized controlled trial / A. J. Guastella et al. // J. Child. Psychol. Psychiatry. 2015. Vol. 56 (4). P. 444−452. doi: https://doi.org/10.1111/jcpp.12305

46. The effect of oxytocin nasal spray on social interaction deficits observed in young children with autism: a randomized clinical crossover trial / C. J. Yatawara et al. // Mol. Psychiatry. 2016. Vol. 21 (9). P. 1225−1231. doi: https://doi.org/10.1038/mp.2015.162

47. STX209 (arbaclofen) for autism spectrum disorders: an 8−week open−label study / C. A. Erickson et al. // J. Autism Dev. Disord. 2014. Vol. 44 (4). P. 958−964. doi: https://doi.org/10.1007/s10803−013−1963−z

48. N−acetylcysteine as an adjunctive therapy to risperidone for treatment of irritability in autism: a randomized, double−blind, placebo−controlled clinical trial of efficacy and safety / M. Nikoo et al. // Clin. Neuropharmacol. 2015. Vol. 38 (1). P. 11−17. doi: https://doi.org/10.1097/wnf.0000000000000063

49. A randomized placebo−controlled pilot study of N−acetylcysteine in youth with autism spectrum disorder / L. K. Wink et al. // Mol. Autism. 2016. Vol. 7. P. 26.

50. A randomised, double blind, placebo−controlled trial of a fixed dose of N−acetyl cysteine in children with autistic disorder / O. M. Dean et al. // Aust. N. Z. J. Psychiatry. 2017. Vol. 51 (3). P. 241−249. doi: https://doi.org/10.1177/0004867416652735

51. D−Cycloserine enhances durability of social skills training in autism spectrum disorder / L. K. Wink et al. // Mol. Autism. 2017. Vol. 8. P. 2.

52. A pilot double−blind placebo−controlled trial of pioglitazone as adjunctive treatment to risperidone: effects on aberrant behavior in children with autism / A. Ghaleiha et al. // Psychiatry Res. 2015. Vol. 229 (1−2). P. 181−187. doi: https://doi.org/10.1016/j.psychres.2015.07.043

53. Comparing efficacy and side effects of memantine vs. risperidone in the treatment of autistic disorder / N. Nikvarz et al. // Pharmacopsychiatry. 2017. Vol. 50 (1). P. 19−25. doi: https://doi.org/10.1055/s−0042−108449

54. Safety and efficacy of memantine in children with autism: randomized, placebo−controlled study and open−label extension / M. G. Aman et al. // J. Child. Adolesc. Psychopharmacol. 2017. Vol. 27 (5). P. 403−412.

55. Williams K., Wray J. A., Wheeler D. M. Intravenous secretin for autism spectrum disorders (ASD) // Cochrane Database Syst. Rev. 2012. Vol. 4. CD003495. doi: https://doi.org/10.1002/14651858.cd003495.pub3

56. Efficacy of low−dose buspirone for restricted and repetitive behavior in young children with autism spectrum disorder: a randomized trial / D. C. Chugani et al. // J. Pediatr. 2016. Vol. 170. P. 45−53. e41−e44.

57. Ghanizadeh A., Ayoobzadehshirazi A. A randomized double−blind placebo−controlled clinical trial of adjuvant buspirone for irritability in autism // Pediatr. Neurol. 2015. Vol. 52 (1). P. 77−81. doi: https://doi.org/10.1016/j.pediatrneurol.2014.09.017

58. Brief Report: Cannabidiol−Rich Cannabis in Children With Autism Spectrum Disorder and Severe Behavioral Problems−A Retrospective Feasibility Study / A. Aran et al. // J. Autism Dev. Disord. 2019. Vol. 49 (3). P. 1284−1288. doi: 10.1007/s10803−018−3808−2

59. Real Life Experience of Medical Cannabis Treatment in Autism: Analysis of Safety and Efficacy / Bar−Lev. Schleider Lihi et al. // Sci. Rep. 2019. Vol. 17, № 9 (1). R. 200. doi: 10.1038/s41598−018−37570−y



Завантажити статтю в форматі PDF (154 KB)
Наверх