Parent-Defined Target Symptoms Respond to Risperidone in RUPP Autism Study: Customer Approach to Clinical Trials

Arnold, L. Eugene; Vitiello, Benedetto; McDougle, Christopher J.; Scahill, Lawrence; Shah, Bhavik; Gonzalez, Nilda M.; Chuang, Shirley; Davies, Mark; Hollway, Jill A.; Aman, Michael G.; Cronin, Pegeen; Koenig, Kathleen; Kohn, Arlene E.; McMahon, Donald J.; Tierney, Elaine

doi:10.1097/00004583-200312000-00011

Cited by 179 publications

(110 citation statements)

References 10 publications

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“…Two large, multisite, randomized, controlled trials have confirmed the short-term efficacy of risperidone for these severe disruptive behaviors in youth with ASDs, [162][163][164][165] and 2 open-label studies, each with a double-blind discontinuation component, have suggested long-term benefits and tolerance. 166,167 Potential adverse effects include but are not limited to excessive appetite and weight gain, insulin resistance, dyslipidemia, hyperprolactinemia, extrapyramidal symptoms, tardive dyskinesia, neuroleptic malignant syndrome, QTc prolongation, dry mouth, urinary retention, constipation, seizures, hematologic abnormalities, and sedation.…”

Section: Psychopharmacologymentioning

confidence: 96%

Management of Children With Autism Spectrum Disorders

Myers¹,

Johnson²

2007

Pediatrics

907

485

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Pediatricians have an important role not only in early recognition and evaluation of autism spectrum disorders but also in chronic management of these disorders. The primary goals of treatment are to maximize the child's ultimate functional independence and quality of life by minimizing the core autism spectrum disorder features, facilitating development and learning, promoting socialization, reducing maladaptive behaviors, and educating and supporting families. To assist pediatricians in educating families and guiding them toward empirically supported interventions for their children, this report reviews the educational strategies and associated therapies that are the primary treatments for children with autism spectrum disorders. Optimization of health care is likely to have a positive effect on habilitative progress, functional outcome, and quality of life; therefore, important issues, such as management of associated medical problems, pharmacologic and nonpharmacologic intervention for challenging behaviors or coexisting mental health conditions, and use of complementary and alternative medical treatments, are also addressed.

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Section: Psychopharmacologymentioning

confidence: 96%

Management of Children With Autism Spectrum Disorders

Myers¹,

Johnson²

2007

Pediatrics

907

485

View full text Add to dashboard Cite

show abstract

“…It is important to distinguish between irritable mood and acts of hostility or aggression, as their mechanisms may be different (Stringaris, 2011). An additional problem with scales such as the ABC is that they were originally developed for people with intellectual disability and include symptoms, such as screaming, that are less common in hfASD (Arnold et al., 2003). Moreover, there is a need for scales that are not just observer‐ or parent‐rated but also incorporate the views of people with ASD themselves.…”

Section: Introductionmentioning

confidence: 99%

Irritability in boys with autism spectrum disorders: an investigation of physiological reactivity

Mikita

Hollocks

Papadopoulos

et al. 2015

Child Psychology Psychiatry

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BackgroundIrritability in people with autism spectrum disorders (ASD) is common and impairing, yet its mechanisms remain understudied. We investigated symptom reporting and mechanisms of irritability in ASD, focusing on the relation between irritability and physiological stress responses.MethodsForty‐seven unmedicated boys with high‐functioning ASD (hfASD) and 23 typically developing boys aged 10–16 years completed a psychosocial stress test. Changes in cortisol, heart rate and heart rate variability throughout the test were recorded. Self‐ and parent‐reported measures of irritability were obtained. Irritability symptom reporting in the hfASD group was compared to two groups of boys without ASD: highly irritable boys (severe mood dysregulation, SMD; n = 40) and healthy‐control boys (HC; n = 30).ResultsBoys with hfASD scored significantly higher on irritability than HC boys, and they reported a pattern of irritability symptoms closely resembling that of boys with SMD. The internal consistency of irritability in hfASD was high by parent‐ and self‐report. Although boys with hfASD showed significant stress‐induced changes in cortisol and heart rate, those who rated themselves as highly irritable had lower cortisol levels throughout the test compared to those low on irritability. Participants rated as highly irritable by their parents showed blunted cortisol and heart rate responses to stress. The effects of irritability on heart rate, but not cortisol, were accounted for by trait anxiety.ConclusionsIrritability can be measured reliably in hfASD and is associated with distinct biological responses to stress.

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“…11 These symptoms often lead parents and caregivers to seek medical evaluation and treatment. 12 Conversely, autistic features have been reported in children who have ADHD, especially in those with the combined type. 13,14 Medical providers often prescribe medications targeting ADHD symptoms in ASD, recognizing the significant impairment that results if these symptoms are left untreated.…”

mentioning

confidence: 99%

Clinical Practice Pathways for Evaluation and Medication Choice for Attention-Deficit/Hyperactivity Disorder Symptoms in Autism Spectrum Disorders

et al. 2012

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BACKGROUND AND OBJECTIVE: Hyperactivity, impulsivity, and inattention (referred to as "ADHD [attention-deficit/hyperactivity disorder] symptoms") occur in 41% to 78% of children with autism spectrum disorders (ASDs). These symptoms often affect quality of life, interfering with learning or interventions that target primary ASD symptoms. This practice pathway describes the guidelines for evaluation and treatment of children and adolescents with ASD and comorbid ADHD symptoms.METHODS: Current research in this area is limited, and, therefore, these recommendations are based on a systematic literature review and expert consensus in the Autism Speaks Autism Treatment Network Psychopharmacology Committee. RESULTS:The recommended practice pathway includes the Symptom Evaluation Pathway for systematic assessment of ADHD symptoms across settings; examination for comorbid sleep, medical, or psychiatric comorbidities that may contribute to symptoms; and evaluation of behavioral interventions that may ameliorate these symptoms. For children for whom medication is being considered to target the ADHD symptoms, the medication choice pathway provides guidance on the selection of the appropriate agent based on a review of available research, assessment of specific advantages and disadvantages of each agent, and dosing considerations.CONCLUSIONS: These recommendations provide a framework for primary care providers treating children who have ASD and ADHD symptoms. Our systematic review of the current evidence indicates the need for more randomized controlled trials of the medications for ADHD symptoms in ASD. There will also be a need for studies of the effectiveness of these practice pathways in the future. Pediatrics 2012;130: S125-S138

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Parent-Defined Target Symptoms Respond to Risperidone in RUPP Autism Study: Customer Approach to Clinical Trials

Cited by 179 publications

References 10 publications

Management of Children With Autism Spectrum Disorders

Management of Children With Autism Spectrum Disorders

Irritability in boys with autism spectrum disorders: an investigation of physiological reactivity

Clinical Practice Pathways for Evaluation and Medication Choice for Attention-Deficit/Hyperactivity Disorder Symptoms in Autism Spectrum Disorders

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