Uso y efectividad de antipsicóticos atípicos en el trastorno del espectro autista

Lizbeth Aida Ortega-Pineda, Lauro Fernández-Cañedo, María Rebeca Toledo-Cárdenas, María Leonor López-Meraz, Luis Isauro García, Genaro Alfonso Coria-Ávila, Jorge Manzo-Denes

Resumen


El trastorno del espectro autista (TEA) pertenece al grupo de trastornos del neurodesarrollo. De acuerdo con la quinta edición del Manual diagnóstico y estadístico de desórdenes mentales (DSM-5) las personas con TEA se caracterizan por presentar alteraciones en la interacción y la comunicación social, así como intereses restringidos y comportamientos repetitivos. Dado que el TEA es un trastorno heterogéneo, se emplean diferentes tratamientos farmacológicos para el control de los cambios conductuales o las comorbilidades que suelen presentarse. Para el manejo de la agresión en niños y adolescentes con TEA, los antipsicóticos de segunda generación o atípicos, como la risperidona y aripiprazol, son los únicos fármacos aprobados por la Administración de Alimentos y Medicamentos. El objetivo de esta revisión es analizar a través de estudios clínicos y revisiones cuál ha sido la efectividad de los antipsicóticos mencionados en pacientes con este diagnóstico que se encuentran entre los 5 y 17 años, rango de edad en la que estos fármacos fueron aprobados para su uso; incluso su administración en menores de 4 años y en adultos. A partir de ello, se confirma que dichos fármacos mejoran las escalas de medición conductual en algunas de las conductas disruptivas presentes en este trastorno; sin embargo, es necesario llevar a cabo nuevos estudios para comparar estos tratamientos con otros fármacos y explorar otras formas de manejos o terapias.

Abstract

Autism Spectrum Disorder (ASD) belongs to the group of neurodevelopmental disorders. According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people with ASD are characterized by alterations in social interaction and communication, as well as restricted interests and repetitive behaviors. Since ASD is a heterogeneous disorder, different pharmacological treatments are used to control behavioral changes or comorbidities that usually occur. For the management of aggression in children and adolescents with ASD, second-generation or atypical antipsychotics, such as risperidone and aripiprazole, are the only drugs approved by the Food and Drug Administration. The objective of this review is to analyze through the analysis of clinical studies and reviews the effectiveness of the antipsychotics in patients with this diagnosis and who are between 5 and 17 years old, the age range in which these drugs were approved for use; including their administration in children under 4 years of age and in adults. From this, it is confirmed that said drugs improve behavioral measurement scales in some of the disruptive behaviors present in this disorder; however, it is necessary to carry out new studies to compare these treatments with other drugs and explore other forms of management or therapies. 

Keywords: ASD, antipsychotics, risperidone, aripiprazole, treatment.


Palabras clave


TEA; antipsicóticos; risperidona; aripiprazol; tratamiento.

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DOI: https://doi.org/10.25009/eb.v14i35.2620

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