(Parikh, Kolevzon & Hollander 2008) 自閉症の攻撃性への治療
J Child Adolesc Psychopharmacol. 2008 Apr;18(2):157-78.
Psychopharmacology of aggression in children and adolescents with autism: a critical review of efficacy and tolerability.
Parikh MS, Kolevzon A, Hollander E.
Mount Sinai School of Medicine, New York, New York 10029, USA.Abstract
BACKGROUND:
Autism is characterized by a clinical triad of symptoms that affect social, language, and behavioral domains. Aggression and self-injury may be associated symptoms of autism and can result in significant harm to those affected as well as marked distress for their families. The precise nature of the relationship between aggressive or self-injurious behavior (SIB) and autism remains unclear and as a result, these symptoms are treated with a broad range of pharmacological approaches. This review seeks to systematically and critically examine the evidence for the pharmacological management of aggression and SIB in children with autism spectrum disorders.
METHOD:
The entire PubMed database was searched for English language biomedical articles on clinical trials with medication in autism spectrum disorders. Studies were selected based on the following inclusion criteria: (1) randomized placebo-controlled trials; (2) a sample population that included children and adolescents; (3) at least one standardized assessment of aggression as a primary outcome measure of the study.
RESULTS:
Twenty one trials with 12 medications were identified. Five medications produced significant improvement as compared to placebo, including tianeptine, methylphenidate, risperidone, clonidine, and naltrexone. Only risperidone and methylphenidate demonstrate results that have been replicated across at least two studies.
CONCLUSIONS:
Although many medications have been studied under placebo-controlled conditions, few produce significant improvement. Additional placebo-controlled trials are needed to increase the number of therapeutic options available in the treatment of aggression in autism.
PMID: 18439113 [PubMed - indexed for MEDLINE]
Psychopharmacology of aggression in children and adolescents with autism: a critical review of efficacy and tolerability. - PubMed - NCBI
自閉症患者の攻撃性における精神薬理学
自閉症の攻撃性に対して有効性が認められた薬剤は、tianeptine, methylphenidate, risperidone, clonidine, and naltrexoneであった。複数の研究で有効性が認められたのは、risperidone と methylphenidate だけであった。
| 一般名 | 商品名 | 適応 |
| risperidone | リスパダール | 統合失調症 |
| methylphenidate | リタリン | ナルコレプシー |
| コンサータ | 18歳未満のADHD |
