PDF(Pubmed)
Abstract：
Many children with autism spectrum disorder (ASD) also have attention-deficit/hyperactivity disorder (ADHD). ADHD in children is associated with increased risk of negative outcomes, and early intervention is critical. Current guidelines recommend psychosocial interventions such as behavioral training as the first line of therapy in managing ADHD symptoms in children with or without ASD. Where symptoms are refractory to these interventions, medications such as stimulants, α2-adrenergic agonist inhibitors, selective norepinephrine reuptake inhibitors, and second-generation antipsychotics are recommended. However, these pharmacotherapies do not have regulatory approval for use in children of preschool age, and evidence on their safety and efficacy in this population has historically been very limited. Since publication of the current guidelines in 2020, several new randomized controlled trials and real-world studies have been published that have investigated the efficacy and tolerability of these medications in preschool children with ADHD, with or without comorbid ASD. Here, we provide a review of the key findings of these studies, which suggest that there is growing evidence to support the use of pharmacological interventions in the management of ADHD in preschool children with comorbid ASD.
摘要：
许多患有自闭症谱系障碍（ASD）的儿童也患有注意力缺陷/多动症（ADHD）。儿童多动症与负面结果的风险增加有关，早期干预至关重要。当前的指南建议将诸如行为训练之类的心理社会干预措施作为治疗有或没有ASD的儿童ADHD症状的第一线治疗。如果这些干预措施难以治疗症状，兴奋剂等药物，α2-肾上腺素能激动剂抑制剂，选择性去甲肾上腺素再摄取抑制剂，推荐第二代抗精神病药。然而,这些药物疗法没有被监管批准用于学龄前儿童，在这一人群中，关于其安全性和有效性的证据历来非常有限。自2020年现行指南发布以来，已经发表了几项新的随机对照试验和现实世界研究，调查了这些药物在患有ADHD的学龄前儿童中的疗效和耐受性。有或没有共病ASD。这里,我们对这些研究的主要发现进行了回顾，这表明，越来越多的证据支持在患有ASD合并症的学龄前儿童的ADHD管理中使用药物干预措施。
