Dados do Trabalho
Título
FLUOXETINE X RISPERIDONE: THE DRUG TREATMENT OF RRB IN PEDIATRIC PATIENTS WITH ASD
Introdução
Autism spectrum disorder (ASD) is the second of the most common neurodevelopmental disorders. This disorder is a defined by persistent deficits in social functioning and the presence of restricted and repetitive behaviors (RRBs). Research on pediatric autistic patients who progress with worst symptoms of RRB and receive efficient drug therapy to improve their quality of life is scarce. Furthermore, these types of drug treatments are difficult adherence in children. In this hypothesis, the patient and the family's insertion is important for resolving the framework.
Objetivo
To differentiate the quality and effectiveness of drug treatment between risperidone and fluoxetine in ASD pediatric patients with RRB.
Método
This is a systematic review, quantitative studies that examined RRB in autistic children birth age 0 through age 18. From the published literature, 52 journal articles were identified and included in this review only 14 with 16 duplicates and 22 excluded. Eligible studies were located through a search of PubMed, Scopus, Cochrane, and LILACS using the following keywords and roots.
Resultados e Conclusões
After taking fluoxetine doses for varying lengths of time, the 568 patients experienced positive effects and side effects like disturbed sleep, diarrhea, vomiting, agitation and irritability, and activation symptoms. Soon, 2391 who used risperidone had good results and some of these children had adverse effects like weight gain, insomnia, and hypertension. During the long-term use of this medication, hyperprolactinemia and gynecomastia were noted. Furthermore, when compared with a placebo, risperidone improved social behaviors and non-verbal communication and decreased obsessive compulsion. Thus, patients using risperidone obtained better scores on assessment scales. Additionally, one of the studies involved 10 children, 3 of whom showed no changes when risperidone withdrawal was indicated, and 7 of whom showed no symptoms after stopping risperidone treatment. Researchers have not found that fluoxetine has completely remission patients' symptoms in studies. Our synthesis of the literature suggests that differences in RRB treatment in ASD pediatric patients are evident. The findings of this study indicate that each individual requires a unique and personalized approach, emphasizing patient and family education, in order to achieve adherence and correct use of the first line of treatment, antipsychotics, preferable risperidone, for the shortest period of time and dose possible.
Palavras Chave
(“autism spectrum disorder” OR autistic disorder OR ASD) AND (stereotypes OR "restrictive and repetitive behavior" OR RRB) AND (children AND child) AND (risperidone OR Risperidal) and changed the medication to (fluoxetine).
Declaração de conflito de interesses de TODOS os autores
I have no conflict of interest to reveal about this scientific production and its presentation.
Referências (se houver)
1. NAGARAJ, Ravishanka et al. Risperidone in Children With Autism: Randomized, Placebo-Controlled, Double-Blind Study. (2005). Journal of Child Neurology / Volume 21, Number 6, June 2006.
2. MANEETON, Narong et al. Risperidone for children and adolescents with autism spectrum disorder: a systematic review. Neuropsychiatric Disease and Treatment 2018:14 1811–1820.
3. KING, Bryan H. et al. Fluoxetine and Repetitive Behaviors in Children and Adolescents With Autism Spectrum Disorder. JAMA October 22/29, 2019 Volume 322, Number 16.
4. HERSCU, Paul et al. The SOFIA Study: Negative Multicenter Study of Low Dose Fluoxetine on Repetitive Behaviors in Children and Adolescents with Autistic Disorder. Journal of Autism and Developmental Disorders, 02 July 2019.
5. McDougle J. D. et al. A Double-blind, Placebo-Controlled Study of Risperidone in Adults With Autistic Disorder and Other Pervasive Developmental Disorders. Arch Gen Psychiatry ;55:633-641, 1998.
6. Shea S. et al. Risperidone in the Treatment of Disruptive Behavioral Symptoms in Children With Autistic and Other Pervasive Developmental Disorders. PEDIATRICS Vol. 114 No. 5 November 2004.
7. Troost W. P. et al. Long-Term Effects of Risperidone in Children With Autism Spectrum Disorders: A Placebo Discontinuation Study. J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 44:11, NOVEMBER 2005.
8. McCracken J. T. et al. RISPERIDONE IN CHILDREN WITH AUTISM AND SERIOUS BEHAVIORAL PROBLEMS. N Engl J Med, Vol. 347, No. 5 · August 1, 2002.
9. Arnold, L. E. et al. RUPP AUTISM NETWORK RANDOMIZED CLINICAL TRIAL OF PARENT TRAINING AND MEDICATION: ONE-YEAR FOLLOW-UP. J Am Acad Child Adolesc Psychiatry. 2012 November ; 51(11): 1173–1184. doi:10.1016/j.jaac.2012.08.028.
10. Roke, Y. et al. Risk of Hyperprolactinemia and Sexual Side Effects in Males 10–20 Years Old Diagnosed with Autism Spectrum Disorders or Disruptive Behavior Disorder and Treated with Risperidone. JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY, Volume 22, Number 6, 2012. DOI: 10.1089/cap.2011.0109
11. Mouti, A. et al. Fluoxetine for Autistic Behaviors (FAB trial): study protocol for a randomized controlled trial in children and adolescents with autism. Trials BioMed Central, v. 15:230, 2014.
12. Zachor, D; Ben-Itzchak, E.From Toddlerhood to Adolescence: Which Characteristics Among Toddlers with Autism Spectrum Disorder Predict Adolescent Attention Deficit/Hyperactivity Symptom Severity? A Long-Term Follow-Up Study. Journal of Autism and Developmental Disorders, 3191-3202, 49(8), 2019.
13. Carrasco, M.;Volkmar, F.; Bloch, M. Pharmacologic treatment of repetitive behaviors in autism spectrum disorders: Evidence of publication bias. Pediatrics, e1301-e1310, 129(5), 2012.
14. Hollander, E. et al. A placebo controlled crossover trial of liquid fluoxetine on repetitive behaviors in childhood and adolescent autism. Neuropsychopharmacology, 582-589, 30(3), 2005.
Área
Transtornos neuropsiquiátricos e distúrbios de aprendizagem
Autores
ISABELLE ARAÚJO LUZ, ÍTALO BARROS ANDRADE, CAROLINE MÂCEDO DE FIGUEIREDO SANTOS