While there is no cure for autism spectrum disorder, psychopharmacologic agents are often used with behavioral and educational approaches to treat its comorbid symptoms of hyperactivity, irritability, and aggression. Studies suggest that at least 50% of persons with autism spectrum disorder receive psychotropic medications during their life span. This selective review examines recent studies about the use of psychotropic medications in persons with autism spectrum disorder. The aim was to focus on randomized controlled trials conducted from 1990 to 2010 on this topic. A comprehensive literature search was performed using PubMed and Cochrane databases. Out of 105 studies identified for the review, only 24 were randomized controlled trials. Thus, despite the common use of these medications in autism spectrum disorder, more controlled studies are needed to determine their long-term efficacy and safety.

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Objective This study aimed to identify factors that influence whether adult psychiatry residents choose to pursue fellowship training, particularly in child psychiatry. The study also assessed how child psychiatry is perceived among adult psychiatry residents as a subspecialty. Methods Electronic surveys were administered to all adult psychiatry residents at the University of Michigan, Henry Ford Health System, and Authority Health. These three programs were selected for geographic convenience. The survey included demographic questions as well as Likert-scale statements that assessed the importance of various factors in determining future career choice. The survey also assessed the agreeability of various statements pertaining to the field of child psychiatry. ResultsThe most important factor for residents in deciding their specialty choice was personal interest, followed by worklife balance, the ability to work directly with patients, and the location of their future job. Over half of residents rated length of training as being "extremely important" or "very important," and fewer than 30% of residents surveyed felt that child psychiatry fellowship was too long. Child psychiatry is widely recognized by residents as having ample job opportunities. However, fewer than 30% of psychiatry residents surveyed rated a high level of interest in child psychiatry. ConclusionThe knowledge of psychiatry residents' views on specialty selection could inform decision making around recruitment efforts. It may also gauge the efficacy and impact of different propositions made to increase child psychiatry recruitment, such as shortening fellowship training in child psychiatry and sponsoring mentorships and interest groups.

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Valproate is a medication used in the treatment of seizures, bipolar disorder, migraines, and behavioral problems. Here we present a case of an 8-year-old boy who presented with hypertensive urgency after initiation of valproate. Primary treatment of his hypertension was ineffective. Blood pressure stabilization was achieved following discontinuation of valproate. Clinicians should be aware of the risk of developing hypertensive urgency with administration of valproate.