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Traitements médicamenteux dans les troubles du spectre de l'autisme : actualités

par Mwali, Eliane ;Delvenne, Véronique
Référence Revue médicale de Bruxelles, 43, 2, page (135-144)
Publication Publié, 2022-03-01

Article révisé par les pairs

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Résumé :

Introduction: The purpose of this article is to provide an overview, based on a review of the scientific literature, of the pharmacotherapy currently used for autism spectrum disorders (ASD) in the pediatric population. It will also be an opportunity to discuss some of the questions raised by research in the field of pharmacotherapy for ASDs and to situate their place in global care. Material and Method: A search of the scientific literature on medical treatments used in autism spectrum disorders was conducted in Pubmed. International guidelines were also used as references for this article. Results: To date, there are no drug treatments available that target key symptoms. Current evidence-based treatments target the comorbid disorders frequently associated with ASD: sleep disorders (melatonine), agitation or irritability (aripiprazole, risperidone, haloperidol), attention deficit disorder with or without hyperactivity (ADHD) (methylphenidate, atomoxétine, guanfacine). The medical treatment of other co-occuring conditions approach does not differ from the recommendations for the general population in the absence of studies including patients with ASD. There is currently not enough scientific evidence to support the use of metabolic agents or alternative methods such as nutritional methods. Conclusions: Treatment research targeting key symptoms has methodological limitations and has not been successful to date. Pharmacotherapy is reserved for ASD-associated comorbidities, presents clinical challenges and requires additional precautions. The indication of psychoactive medication for the treatment of comorbidities associated with ASD requires a thorough assessment of the individual clinical situation, of the patient and his environment, must exclude a somatic cause, and must be articulated with other non-pharmacological treatments in a multidisciplinary, evolving and coordinated care plan.