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首页> 外文期刊>Journal of the Canadian Academy of Child and Adolescent Psychiatry >Stimulant Withdrawal in a Child with Autism Spectrum Disorder and ADHD - A Case Report
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Stimulant Withdrawal in a Child with Autism Spectrum Disorder and ADHD - A Case Report

机译：自闭症谱系障碍和多动症儿童兴奋性戒断-病例报告

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Objective To consider whether the concepts of tolerance and withdrawal to stimulant medications apply to a preadolescent female, affected by autism spectrum disorder (ASD) and treated for associated attention-deficit/hyperactivity disorder (ADHD). Methods We describe the case history and review scientific English language literature pertaining to acute withdrawal effects associated with methylphenidate and amphetamine derivatives in children. Results An 11-year-old female with ASD and ADHD referred to our clinic experienced vomiting, headaches, and light sensitivity following abrupt discontinuation of methylphenidate; she subsequently presented with migraines and marked malaise immediately after a dose reduction in lisdexamfetamine. Evidence supports the notion that ADHD symptoms in children with ASD can be effectively treated with methylphenidate; however, beneficial effects are less robust relative to children with a primary ADHD diagnosis. Children affected by ASD are also more susceptible to adverse effects. Literature on withdrawal from stimulants in children is limited to case studies; in contrast, in the adult population more information is available, especially in adults with substance abuse disorders. Adults experiencing stimulant withdrawal often experience depression, fatigue, changes in appetite, and insomnia or hypersomnia. Conclusions We argue that tolerance to stimulants was conceivably developing in this young female, and consequently discontinuation of methylphenidate and dose reduction of lisdexamfetamine resulted in withdrawal symptoms. Children with ASD are more sensitive to stimulant medications and we wonder whether this extends to an increased sensitivity to developing tolerance to stimulant medication. Clinicians ought to be vigilant about the emergence of symptomology suggestive of withdrawal phenomena following stimulant discontinuation.
机译：目的探讨对兴奋剂的耐受性和戒断概念是否适用于患有自闭症谱系障碍（ASD）并治疗相关的注意力不足/多动症（ADHD）的青春期前女性。方法我们描述了病例历史并回顾了与儿童哌醋甲酯和苯丙胺衍生物相关的急性戒断反应有关的科学英语文献。结果11岁的ASD和ADHD的女性转诊至我们的诊所后突然停用哌醋甲酯出现呕吐，头痛和光敏性。赖斯地非明减少剂量后，她随后出现偏头痛并明显不适。有证据支持哌醋甲酯可有效治疗ASD儿童的ADHD症状。然而，相对于患有原发性多动症的儿童来说，有益的作用较弱。受ASD影响的儿童也更容易受到不良影响。关于从儿童中退出兴奋剂的文献仅限于案例研究。相反，在成年人口中，可以获得更多信息，尤其是在患有药物滥用疾病的成年人中。患有兴奋性戒断的成年人经常会感到沮丧，疲劳，食欲改变，失眠或失眠。结论我们认为这名年轻女性对兴奋剂的耐受性正在上升，因此，哌醋甲酯的停用和赖氨苯丙胺剂量的减少会导致戒断症状。患有自闭症的儿童对兴奋剂药物更敏感，我们想知道这是否会扩大对发展对兴奋剂药物的耐受性的敏感性。临床医生应警惕症状的出现，这些症状提示在停用兴奋剂后出现戒断现象。

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