阿立哌唑
易怒
利培酮
自闭症
荟萃分析
精神科
随机对照试验
奎硫平
医学
非定型抗精神病薬
安慰剂
心理学
不利影响
抗精神病药
儿科
内科学
精神分裂症(面向对象编程)
焦虑
替代医学
病理
作者
Merrick S. Fallah,Mateen Shaikh,Binod Neupane,Daniel Rusiecki,Teresa Bennett,Joseph Beyene
出处
期刊:Journal of Child and Adolescent Psychopharmacology
[Mary Ann Liebert]
日期:2019-04-01
卷期号:29 (3): 168-180
被引量:60
标识
DOI:10.1089/cap.2018.0115
摘要
Objective: Irritability is common in pediatric autism spectrum disorder (ASD) patients. This can have major implications in child development, receptivity to behavioral therapy, as well as child and caregiver well-being. A systematic review and network meta-analysis were conducted to assess the efficacy and safety of atypical antipsychotics in treating irritability in these patients. Methods: Studies were identified from Medline, Embase, and PsycINFO from inception to March 2018. The clinical trials database was reviewed. Studies were included if they were a double-blind, randomized controlled trial utilizing the Aberrant Behavior Checklist Irritability (ABC-I) to measure the efficacy of atypical antipsychotic monotherapy. Data extraction was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses for network meta-analysis guidelines. The main outcome was the reduction in irritability score using the ABC-I subscale from baseline. Results: Eight trials comparing four interventions—risperidone, aripiprazole, lurasidone, and placebo in 878 patients, were included. Both risperidone and aripiprazole had significantly reduced ABC-I scores than placebo. Estimates of mean differences (95% credible intervals) were risperidone, −6.89 (−11.14, −2.54); aripiprazole, −6.62 (−10.88, −2.22); and lurasidone, −1.61 (−9.50, 6.23). Both risperidone and aripiprazole had similar safety. There were only eight studies included in the analysis, however, sample sizes were not small. Variance in reporting of adverse effects limited the quality of safety analysis. Conclusion: Risperidone and aripiprazole were the two best drugs, with comparable efficacy and safety in pediatric ASD patients. These two medications could be beneficial in improving irritability in these patients.
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