社團法人臺灣臨床藥學會

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【綜合評述】自閉症類群障礙症及其藥物治療發展現況
An Update on Autism Spectrum Disorder and Its Pharmacotherapy
自閉症類群障礙症、兒童及青少年、藥物治療、Autism Spectrum Disorder, Children and Adolescents, Drug Therapy
蘇恆瑤Heng-Yao Su1 、顧德璉Te-Lien Ku1,*
1汐止國泰綜合醫院藥劑科
自閉症類群障礙症是一種常見於兒童及青少年的先天性神經發展疾病,其核心症狀包括社交互動與溝通能力的缺損,以及侷限且重複的興趣與行為。自閉症患者多半呈現自我封閉式的孤獨,以及與人建立社會連結的困難。治療方面,現階段以語言治療、行為治療、社交技巧訓練為主;藥物治療上,risperidone 和aripiprazole 是目前少數被美國食品藥物管理局核准用於治療自閉症之藥物,這些非典型抗精神病藥物已被證實可治療自閉症相關之易怒、攻擊及自傷行為,惟須注意代謝相關副作用。其他藥物如注意力不足過動症藥物、抗癲癇藥物及抗憂鬱藥物於臨床上皆用以治療與自閉症相關之行為或情感症狀。本文簡述自閉症類群障礙症的流行病學、致病機轉、診斷標準及臨床表現,並針對現行藥物治療選擇及未來新藥發展方向進行文獻回顧。
 
Autism spectrum disorder is a congenital neurodevelopmental disease, characterized by impaired social interaction and communication ability and repetitive and limited interests and behavior. Most children and adolescents with autism exhibit loneliness and difficulties in establishing interpersonal relationships. Speech–language therapy, behavioral therapy, and social skill training are mainstays of autism treatment, whereas medication plays an auxiliary role. Currently, no evidence has indicated that drugs can effectively treat all core symptoms of autism, and atypical antipsychotics, particularly risperidone and aripiprazole, are the only two medications approved by the U.S. Food and Drug Administration for treating autism-related irritability. Other medicines, such as drugs for attention deficit hyperactivity disorder, antiepileptic drugs, and antidepressants, are still used clinically as adjuvant therapies to treat autism-related behaviors or emotional symptoms. This article reviews the research on pharmacologic treatment for autism and summarizes the potential pharmacotherapeutic options.

Summited for publication: 2021.1.4; Accepted for publication: 2021.3.24
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