Pharmacologic Treatment for the Core Deficits and Associated Symptoms of Autism in Children

West, Lis; Waldrop, Julee; Brunssen, Susan

doi:10.1016/j.pedhc.2008.12.001

Cited by 53 publications

(37 citation statements)

References 34 publications

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“…One paper reviewed all randomized, controlled, clinical trials of pharmacological interventions and concluded that no treatment met the criteria for even 'probably efficacious' [167]. A recent paper reviewed all studies conducted in children with ASDs and concluded that there was minimal success in treating the core deficits; only risperidone has been approved for use in children [171]. It has been estimated that psychotropic drug treatments for outpatient children and adolescents with ASDs range from 25 to 55% (Table 5) [172][173][174].…”

Section: Treatmentmentioning

confidence: 99%

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Autism: an emerging ‘neuroimmune disorder’ in search of therapy

Theoharides

Kempuraj

Redwood³

2009

Expert Opinion on Pharmacotherapy

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Background: Autism spectrum disorders (ASDs) are neurodevelopmental disorders characterized by difficulties in communication and by repetitive and stereotypic behaviors, as well as by social impairment, attention, cognitive, and learning defects. ASDs present in early childhood and their prevalence has increased significantly to 1/150 children. Despite a number of theories, the actual reasons for this increase are still not clear. There is no reliable screening test, and no definite pathogenesis or curative therapy. Consequently, there is a major gap hampering development of effective treatments. Objective: To review recent publications on ASDs pathogenesis and treatment with emphasis on neuroimmune processes and new therapeutic approaches. Methods: Mostly original papers (450) on epidemiology, possible pathogenesis or treatment of ASDs in Medline from 1990 to May 2009 were reviewed. All authors contributed to this review. Results/conclusion: Increased oxidative stress and immune dysregulation are present in ASDs. Mastcell activation may contribute to gut-blood-brain barrier disruption and brain inflammation. No effective treatments have emerged. Well-designed clinical trials with nonpsychotropic drugs were few and ASD characteristics varied considerably, making conclusions difficult. Psychotropic drugs are often used for stereotypic and aggressive behaviors. Unique combinations with antioxidant and anti-inflammatory flavonoids hold promise. New potential translational research areas and possible treatments are suggested.

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Section: Treatmentmentioning

confidence: 99%

“…Almost 20% of ASD children are prescribed some antipsychotic drug [171,174,177]. These drugs [178], especially the newer atypical compounds [179,180], are used often in ASDs, mostly to control irritability and stereotypic -sometimes self-injurious -behavior [178][179][180][181][182].…”

Section: Antipsychoticsmentioning

confidence: 99%

Autism: an emerging ‘neuroimmune disorder’ in search of therapy

Theoharides

Kempuraj

Redwood³

2009

Expert Opinion on Pharmacotherapy

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“…Unfortunately, stimulants are not as effective in the autistic population and have increased adverse effects when compared with the children with isolated ADHD. Repetitive behaviour and compulsions as well as mood lability, irritability and aggression may be decreased with anticonvulsant agents [22,30,34,38].…”

Section: Management Of Behaviour Problems-psychopharmacologymentioning

confidence: 99%

“…In general, children and adolescents with ASD have increased sensitivity and intensity of adverse effects to minimal doses of medication when compared with normally developing peers. As a result, the majority of studies begins with low doses and titrates upward based on response and tolerance [38].…”

Section: Management Of Behaviour Problems-psychopharmacologymentioning

confidence: 99%

Clinical practice

Olivié

2012

Eur J Pediatr

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The prevalence of autism spectrum disorder (ASD) has increased considerably in the past decades. The primary care paediatrician plays an important role not only in the early recognition of ASD but also in its chronic management. Paediatricians need to be comfortable with the global care of children with ASD. The diagnostic assessment of children with ASD comprises the medical investigations to identify associated or underlying medical conditions. The most important associated conditions are seizures, feeding and gastrointestinal problems, sleep disturbances and dental abnormalities. The care of ASD patients is very demanding since along with the purely medical issues there are challenging behavioural and psychiatric conditions that need consideration and professional skills.

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“…[36] Some common trends in prescription practices include the use of a wide range of medication, such as antipsychotics for self-injury and aggression and, to a lesser degree, antiepileptic drugs and antidepressants. [37,38] However, risperidone and aripiprazole (both atypical antipsychotics) are currently the only two psychotropic medications that are US FDA approved for the treatment of problems associated with ASD; they are approved for irritability associated with ASD in children. [39] Furthermore, while these medications are only FDA approved for children with ASD, they are widely prescribed for adults with ASD in clinical practice.…”

Section: Pharmacotherapymentioning

confidence: 99%

Issues in the Management of Challenging Behaviours of Adults with Autism Spectrum Disorder

et al. 2011

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Autism spectrum disorder (ASD) is a particularly important risk factor for challenging behaviours such as aggression, tantrums, self-injury and pica. Adults with ASD have rarely been studied with respect to these problems. This is particularly disconcerting since there are far more adults than children with ASD. In addition, because of adults' increased physical size and longer history of these problems, treating these behaviours effectively is important. Psychological methods, particularly applied behaviour analysis, and pharmacotherapy have been the most frequently addressed treatments for challenging behaviours associated with ASD in the research literature. In many cases, challenging behaviours have clear environmental antecedents. In these cases, behavioural interventions, such as applied behaviour analysis, should be used to reduce the behaviours. When environmental factors cannot be identified or when challenging behaviours are very severe, pharmacological treatments may be necessary in combination with behavioural interventions. Newer antipsychotics are the most researched medications for use with this population. Currently, risperidone and aripiprazole are the only medications that have US FDA approval for the treatment of behaviours associated with ASD, specifically irritability; however, they are indicated for use in children not adults. It is important not to use medications unnecessarily, due to possible side effects associated with their use. Based on available research, some recommendations for the treatment of challenging behaviours of adults (and children) with ASD include the use of functional assessment, side-effect monitoring of medications and behavioural methods whenever possible. Additionally, future research in this area needs to focus more on adults, as most current research has used child samples.

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Pharmacologic Treatment for the Core Deficits and Associated Symptoms of Autism in Children

Cited by 53 publications

References 34 publications

Autism: an emerging ‘neuroimmune disorder’ in search of therapy

Autism: an emerging ‘neuroimmune disorder’ in search of therapy

Clinical practice

Issues in the Management of Challenging Behaviours of Adults with Autism Spectrum Disorder

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