Treatment of Aggressive Behavior and Agitation in an 11-Year-Old Boy with Co-Occurring Autism and ADHD: A Case Report and Literature Review on the Use of Intravenous Valproate in Emergency Psychiatry

被引:0
作者
Carta, Alessandra [1 ]
Cavassa, Vanna [1 ,2 ]
Puci, Mariangela Valentina [3 ]
Averna, Roberto [4 ]
Sotgiu, Giovanni [3 ]
Valeri, Giovanni [4 ]
Vicari, Stefano [4 ,5 ]
Sotgiu, Stefano [1 ,2 ]
机构
[1] Univ Hosp Sassari, Dept Med Surg & Pharm, Child & Adolescent Neuropsychiat Unit, Viale San Pietro 43-B, I-07100 Sassari, Italy
[2] Univ Cagliari, Dept Biomed Sci, Branch Sassari, Sect Neurosci & Clin Pharmacol, I-09121 Cagliari, Italy
[3] Univ Sassari, Dept Med Surg & Pharm, Clin Epidemiol & Med Stat Unit, I-07100 Sassari, Italy
[4] Bambino Gesu Childrens Hosp OPBG, Sci Inst Res Hospitalizat & Healthcare, Child & Adolescent Neuropsychiat Unit, I-00146 Rome, Italy
[5] Catholic Univ, Life Sci & Publ Hlth Dept, Rome, Italy
关键词
autism; ADHD; agitation; intravenous valproate; BIPOLAR DISORDER; DOUBLE-BLIND; PHARMACOLOGICAL MANAGEMENT; SODIUM VALPROATE; OPEN-LABEL; ADD-ON; MANIA; CHILDREN; EFFICACY; SAFETY;
D O I
10.3390/jcm13123573
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Autism spectrum disorder (ASD) is a persistent neurodevelopmental disorder frequently co-occurring with attention-deficit/hyperactivity disorder (ADHD) and behavior-related disorders. While behavioral therapy is the first-line option to manage the core symptoms of ASD, pharmacological therapy is sometimes needed to treat acute problems, such as agitation and aggressive behaviors. Recent guidelines recommend the use of neuroleptics to reduce psychomotor agitation in patients with ASD. However, as children with ASD are often drug-resistant, alternative treatments are often justified. Reports from the literature have indicated that intravenous valproate (IV-VPA) can be effective in reducing agitation in psychiatric patients, with a lower frequency of adverse events compared to conventional treatments. However, as the related findings are occasionally inconsistent, IV-VPA is not yet an approved option in the context of clinical psychiatry. We aim to improve knowledge of the IV-VPA treatment option for emergency psychiatric treatment in pediatric patients. Methods: We report the case of an 11-year-old boy suffering from a complex neurodevelopmental condition who experienced a psychotic episode with severe aggressive and disruptive behaviors and was successfully treated with IV-VPA. Furthermore, we provide an updated literature review on this topic. Conclusion: In our case, first-line therapies proved to be ineffective. To the contrary, IV-VPA led to safe and prompt clinical success, which is in line with other reports. Based on our literature review, IV-VPA can be highly effective and reduces the risk of adverse events that frequently occur with the use of high-dose standard medications in emergency psychiatry.
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页数:22
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