■自闭症谱系障碍(ASD)是一种早发性疾病,在儿童中的患病率为1%,据报道,残疾调整寿命为431万。易怒是一种与ASD相关的具有挑战性的行为,药物开发滞后。更具体地说,药物治疗的有效性可能是有限的高不良反应(考虑副作用和患者的药物敏感性);因此,药物干预的可能益处必须与每位患者的潜在不良事件相平衡.
■在回顾了ASD相关易怒的神经病理生理学之后,根据作用机制和作用目标,我们详细介绍了基于随机对照试验的新兴药物在治疗中的获益和耐受性.
■继续服用利培酮和阿立哌唑,美金刚的单一疗法可能是有益的。此外,N-乙酰半胱氨酸,加兰他敏,萝卜硫素,塞来昔布,棕榈酰乙醇胺,己酮可可碱,辛伐他汀,米诺环素,金刚烷胺,孕烯醇酮,泼尼松龙,利鲁唑,propentofylline,吡格列酮,还有托吡酯,利培酮的所有辅料,可乐定和哌醋甲酯优于安慰剂。这些作用是通过谷氨酸,γ-氨基丁酸能,炎症,氧化,胆碱能,多巴胺能,和血清素能系统。据报道,所有药物都是安全和可耐受的。考虑到样本量,后续行动,和效果大小,需要进一步的研究。随着药物的发展,建议重新定位和合并由作用机制支持的现有药物。
UNASSIGNED: Autism spectrum disorder (ASD) is an early-onset disorder with a prevalence of 1% among children and reported disability-adjusted life years of 4.31 million. Irritability is a challenging behavior associated with ASD, for which medication development has lagged. More specifically, pharmacotherapy effectiveness may be limited against high adverse effects (considering side effect profiles and patient medication sensitivity); thus, the possible benefits of pharmacological interventions must be balanced against potential adverse events in each patient.
UNASSIGNED: After reviewing the neuropathophysiology of ASD-associated irritability, the benefits and tolerability of emerging medications in its treatment based on randomized controlled trials were detailed in light of mechanisms and targets of action.
UNASSIGNED: Succeeding risperidone and aripiprazole, monotherapy with memantine may be beneficial. In addition, N-acetylcysteine, galantamine, sulforaphane, celecoxib, palmitoylethanolamide, pentoxifylline, simvastatin, minocycline, amantadine, pregnenolone, prednisolone, riluzole, propentofylline, pioglitazone, and topiramate, all adjunct to risperidone, and clonidine and methylphenidate outperformed placebo. These effects were through glutamatergic, γ-aminobutyric acidergic, inflammatory, oxidative, cholinergic, dopaminergic, and serotonergic systems. All medications were reported to be safe and tolerable. Considering sample size, follow-up, and effect size, further studies are necessary. Along with drug development, repositioning and combining existing drugs supported by the mechanism of action is recommended.