这项研究的目的是评估自闭症谱系障碍(ASD)患者常用的精神病和癫痫药物的益处和不良反应(AE)。
作为全国自闭症治疗效果调查的一部分,我们报告了505名参与者对26种精神病药物和癫痫发作药物的评级.每种药物都用标准化的总体获益量表进行评级,总体AE,和受影响的特定症状。报告使用频率和净感知效益(总体效益减去总体AE)。
大多数药物被评价为具有比AE略大的益处。六种药物(拉莫三嗪,奥卡西平,可乐定,胍法辛,Buspirone,和舍曲林)的获益评级是其不良评级的两倍以上。相反,一些药物的净效益评级略为负(不良事件比平均效益差),包括Adderall,帕罗西汀,喹硫平,奥氮平,还有托吡酯.然而,个人对福利和不良事件的评级差异很大,表明对药物的临床反应是高度可变的,所以这些分数只是代表平均值。提供了18种不同症状中每种症状的顶级药物(具有最高净感知益处的药物)的排名。这可能提供了一些临床指导,以确定哪种药物对于给定的症状最值得考虑。调查结果与临床试验结果的比较显示,在药物益处方面总体上具有良好的一致性,但存在一些差异;在某些情况下,差异是因为临床试验没有评估本次调查评估的所有症状。
希望医生和他们的病人能发现调查结果有助于为特定症状选择最有希望的药物。以及监控可能的收益和不良事件,特别是对于在ASD人群中很少或没有进行过研究的药物。
The objective of this study was to provide an evaluation of the benefits and adverse effects (AEs) of psychiatric and seizure medications commonly used for individuals with autism spectrum disorder (ASD).
As part of the National Survey on Treatment Effectiveness for Autism, we report ratings of 26 psychiatric and seizure medications by 505 participants. Each medication was rated with a standardized scale for overall benefits, overall AEs, and specific symptoms affected. The frequency of use and net perceived benefit (overall benefit minus overall AE) are reported.
Most medications were rated as having a slightly greater benefit than AE. Six medications (lamotrigine, oxcarbazepine, clonidine, guanfacine, buspirone, and sertraline) had benefit ratings that were more than twice their adverse rating. Conversely, some medications had slightly negative net benefit ratings (worse AEs than benefits on average), including Adderall, Paroxetine, Quetiapine, Olanzapine, and Topiramate. However, there were wide variations in individual ratings of benefit and AEs, suggesting that clinical response to medications was highly variable, so these scores simply represent averages. A ranking of the top medications (those with the highest net perceived benefit) for each of 18 different symptoms is provided, which may provide some clinical guidance as to which medications may be most worth considering for a given symptom. A comparison of the survey results with the results of clinical trials shows generally good agreement in terms of medication benefits with some differences; in some cases the differences are because the clinical trials did not assess all of the symptoms assessed by this survey.
It is hoped that physicians and their patients will find the survey results useful in selecting the most promising medications for a given symptom, and also for monitoring for likely benefits and AEs, especially for medications for which few or no studies have been carried out in ASD populations.