Control of psychomotor agitation and aggressive behavior in patients with autistic disorder: a retrospective chart review

Abstract

-Objective:To evaluate the efficacy of pharmacotherapy on the symptoms of psychomotor agitation and aggressive behavior in a sample of patients with autistic spectrum disorder. Method: The charts of all patients with a diagnosis of autistic spectrum disorder, receiving care for psychomotor agitation and/or aggressive behavior in two psychiatric outpatient departments between 2001 and 2006, were reviewed. The Clinical Global Impression-Severity and -Improvement scales (CGI-S and CGI-I) were applied to the data retrieved from the charts. Results: The majority of the 26 patients included were treated with second-generation antipsychotics. A positive, statistically significant correlation was found between the implementation of pharmacotherapy and a reduction in CGI-S scores (p<0.05). Treatment response in patients with no mental retardation was better than in those mentally retarded (p<0.05). The majority of patients in whom clinical improvement was found following implementation of treatment had participated in at least one form of intervention therapy in addition to the principal treatment (p<0.05). Conclusion: Secondgeneration antipsychotics seem to reduce psychomotor agitation and aggressive behavior in patients with autistic spectrum disorder; however, further studies are required to evaluate the side effects of these drugs in relation to their beneficial effects.Key wordS: antipsychotics, pharmacological, retrospective, autistic disorder, treatment. Controle da agitação psicomotora e agressividade em pacientes com autismo: estudo retrospectivo de revisão de prontuárioResumo -Objetivo: Avaliar a eficácia do tratamento farmacológico dos sintomas de agitação psicomotora e agressividade em amostra de pacientes com transtorno do espectro autista. Método: Foram revisados os prontuários de pacientes com diagnóstico de transtorno do espectro autista que procuraram atendimento por apresentarem agitação psicomotora e/ou heteroagressividade, atendidos entre 2001 e 2006, em dois ambulatórios de psiquiatria. Para avaliação da evolução dos pacientes aplicou-se às informações do prontuário a escala de Impressão Clínica Global Sintomas (ICG-S) e a Impressão Clínica Global Melhora (ICG-M). Resultados: A maioria dos 26 pacientes estava em tratamento com antipsicóticos de segunda geração. Houve correlação positiva e estatisticamente significativa entre a introdução do tratamento farmacológico e a redução nos escores da ICG-S (p<0,05). A evolução do tratamento farmacológico foi melhor para os pacientes sem retardo mental do que para aqueles com retardo mental (p<0,05). A maioria dos pacientes que obteve melhora clínica com o tratamento participava de ao menos uma intervenção auxiliar ao tratamento principal (p<0,05). Conclusão: os antipsicóticos de segunda geração parecem reduzir a agitação psicomotora e agressividade em pacientes com transtorno do espectro autista no Brasil. É necessário que se avaliem os efeitos colaterais em relação aos efeitos benéficos dessas drogas.

Pervasive developmental disorder in the children of immigrant parents: comparison of different assessment instruments

“…According to the Diagnostic and Statistical Manual of Mental Disor ders, 4 th Edition (DSMIV), the PDD group has five diffe rent cate gories: autistic disorder, Rett's disorder, childhood di sintegrative disorder, Asperger syndrome and pervasive de ve lopmental disorder -not otherwise specified (PDDNOS) 1 . Associated symptoms such as hyperactivity 2 , aggressi veness, epilepsy and insomnia are common and aggravate the clinical condition, which in some cases may require pharmacological management 3 . Bearing in mind that the neurobiological origin of PDDs remains to be fully clarified, there are no specific diagnostic markers of this disorder.…”

Frequency of symptoms of attention deficit and hyperactivity disorder in autistic children

“…Autism is a complex developmental disorder with multiple etiologies and different severity degrees 25 . These disorder is commonly associated with other morbidities [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] .…”

“…We can also think that the association of autism and ADHD can be comorbidity or still a distinct phenotype of autism. Elucidating this problem can predict the prognosis for these children and can be very important for therapeutic planning for autistic children 24 , especially because those children have been treated with different classes of medications 25 . This study aims to estimate the frequency of symptoms of ADHD in patients with autistic disorder.…”

Update on autism: A review of 1300 reports published in 2008

“…They also reviewed the possible problems of weight gain and tardive dyskinesia. ''Second-generation antipsychotic medications" were studied by others [303] who reported that these medications seem to reduce psychomotor agitation and aggressive behavior. Fido and Al-Saad [304] reported on olanzapine in particular, concluding that this treatment can alleviate irritability, hyperactivity, and lethargy.…”