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Master Thesis

Efficacité et tolérance de la clozapine sur les comportements-défis des patients adultes présentant un trouble du spectre de l’autisme

Abstract : Patients with autism spectrum disorder (ASD) often show aggressive behaviors, which interfere with their quality of life. Some drug therapies as well as some behavioral therapies are able to improve the challenging behaviors of patients with ASD. Among drug treatments, atypical antypsychotics show the highest standards of proof for this indication. Nevertheless, there is an important ratio of non-responders, from 30 to 50%, depending on the molecules. Hence, clozapine has been offered as treatment for the care of aggresive behaviors resistant to other drugs.
The use of clozapine for the challenging behaviors of patients with ASD was described in several case studies, all of which state its efficiency, but still provide a limited amount of data. Moreover, studies of its long-term efficacity and tolerability are still lacking. In this context, we made a replication-study of the investigation by Béhérec et al. (2011), covering a larger population of patients with ASD and including a study of long-term efficacity and tolerability of clozapine.
The results highlight a distinct effectivity of clozapine for reducing (with an average reduction of 65%) challenging behaviors of objects-destroying and other-assaulting, and also of self-harming, which is a new item of information. We have also brought to light a positive effect of clozapine on the quality of life of patients with ASD. We have been able to assess for the first time the long-term tolerability and efficacity of clozapine and to show that its effects continue over time, with good tolerance, during 8 to 15 years.
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Master Thesis
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Submitted on : Monday, January 15, 2018 - 10:49:49 AM
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Fanny Szymoniak. Efficacité et tolérance de la clozapine sur les comportements-défis des patients adultes présentant un trouble du spectre de l’autisme. Médecine humaine et pathologie. 2017. ⟨dumas-01684058⟩

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