Pharmacotherapy of Autism and Related Disorders

Blankenship, Kelly; Erickson, Craig A.; McDougle, Christopher J.

doi:10.3928/00485713-20100330-06

Cited by 6 publications

(3 citation statements)

References 37 publications

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“…Alpha 2 agonists, mood stabilizers, and anticonvulsants are also employed to target aggression, SIB, and severe tantrums in ASDs, but less convincing evidence supports the effectiveness of these drug classes (Stigler and McDougle, 2008). Following large placebo-controlled trials which demonstrated relatively robust reduction in irritability with treatment as measured by the Aberrant Behavior Checklist–Irritability subscale (ABC-I), which measures the severity of aggressive, self-injurious, and tantrum behaviors, risperidone and aripiprazole have been FDA-approved for treatment of irritability in youth with autistic disorder (Blankenship et al, 2010; McCracken et al, 2002; Owen et al, 2009). Additionally, positive and negative predictors of medication treatment response have recently been reported on by Arnold et al (2010) using data compiled during the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network placebo-controlled trial of risperidone in youth with autistic disorder (Arnold et al, 2010; McCracken et al, 2002).…”

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confidence: 99%

Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: A chart review study

Adler

Wink

Early

et al. 2014

Autism

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Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p < 0.0001), diagnosis of autistic disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain.

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mentioning

confidence: 99%

Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: A chart review study

Adler

Wink

Early

et al. 2014

Autism

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“…Following several large randomized, placebo-controlled trials that demonstrated robust reduction in aggressive behavior with treatment in youth with ASD, risperidone and aripiprazole were approved by the US Food and Drug Administration (FDA) for the treatment of irritability in this population. 45 – 47 First-generation antipsychotics, antiepileptic medications (AEDs), mood stabilizers, and several glutamatergic modulators are also frequently employed for the treatment of ASD-associated irritability, though with less robust evidence supporting their use ( Table 1 for a brief review of selected controlled pharmacologic trials in ASD).…”

Section: Pharmacological Treatments Of Aggressionmentioning

confidence: 99%

Aggression in autism spectrum disorder: presentation and treatment options

Fitzpatrick¹,

Srivorakiat²,

Wink³

et al. 2016

NDT

100

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent difficulties in social communication and social interaction, coupled with restricted, repetitive patterns of behavior or interest. Research indicates that aggression rates may be higher in individuals with ASD compared to those with other developmental disabilities. Aggression is associated with negative outcomes for children with ASD and their caregivers, including decreased quality of life, increased stress levels, and reduced availability of educational and social support. Therapeutic strategies including functional behavioral assessment, reinforcement strategies, and functional communication training may have a significant impact in reducing the frequency and intensity of aggressive behavior in individuals with ASD. Pharmacologic treatments, particularly the use of second-generation antipsychotics, may also be of some benefit in reducing aggression in individuals with ASD. With the ever-increasing rate of ASD diagnosis, development of effective therapeutic and pharmacologic methods for preventing and treating aggression are essential to improving outcomes in this disorder.

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“…Several forms of intervention have been proposed for reducing CB in people with ASD, including medications ( Malone et al, 2005 ; Blankenship et al, 2010 ; McPheeters et al, 2011 ; Sawyer et al, 2014 ), behavioral interventions ( Scotti et al, 1996 ; Didden et al, 2006 ; Machalicek et al, 2007 , 2016 ; Lydon et al, 2013 ; Fettig and Barton, 2014 ; Erturk et al, 2018 ; MacNaul and Neely, 2018 ; Weston et al, 2018 ; Inoue, 2019 ), cognitive/emotion-oriented interventions ( Neal and Barton Wright, 2003 ; Zetteler, 2008 ; O’Neil et al, 2011 ; Cotelli et al, 2012 ; Subramaniam and Woods, 2012 ; Doyle et al, 2013 ), sensory stimulation/integration interventions ( Lang et al, 2012 ; Barton et al, 2015 ; Case-Smith et al, 2015 ; Leong et al, 2015 ; Wan Yunus et al, 2015 ; Watling and Hauer, 2015 ), music therapy ( Gold et al, 2006 ; Stephenson, 2006 ; Simpson and Keen, 2011 ; James et al, 2015 ; Fakhoury et al, 2017 ), psychosocial interventions ( Seida et al, 2009 ; Reichow et al, 2013 ; Vanderkerken et al, 2013 ; Bishop-Fitzpatrick et al, 2014 ; Lim, 2019 ), communication training ( Mirenda, 1997 ; Goldstein, 2002 ; Lequia et al, 2012 ; Walker and Snell, 2013 ; Gerow et al, 2018 ; Gregori et al, 2020 ), physical exercises ( Eggermont and Scherder, 2006 ; Ogg-Groenendaal et al, 2014 ; Sorensen and Zarrett, 2014 ; Forbes et al, 2015 ; Bremer et al, 2016 ), and others ( McDonnell et al, 2008 ; Tanner et al, 2015 ; Lindgren et al, 2016 ; Ferguson et al, 2019 ; Walker et al, 2021 ; Wahman et al, 2022 ). Despite the wide av...…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a system for the prediction of challenging behaviors of people with autism spectrum disorder based on a smart wearable shirt: A mixed-methods design

Romano

Hoffman

Lotan

et al. 2022

Front. Behav. Neurosci.

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BackgroundMost people with autism spectrum disorder (ASD) present at least one form of challenging behavior (CB), causing reduced life quality, social interactions, and community-based service inclusion.ObjectivesThe current study had two objectives: (1) to assess the differences in physiological reaction to stressful stimuli between adults with and without high-functioning ASD; (2) to develop a system able to predict the incoming occurrence of a challenging behaviors (CBs) in real time and inform the caregiver that a CB is about to occur; (3) to evaluate the acceptability and usefulness of the developed system for users with ASD and their caregivers.MethodsComparison between physiological parameters will be conducted by enrolling two groups of 20 participants with and without ASD monitored while watching a relaxing and disturbing video. To understand the variations of the parameters that occur before the CB takes place, 10 participants with ASD who have aggressive or disruptive CBs will be monitored for 7 days. Then, an ML algorithm capable of predicting immediate CB occurrence based on physiological parameter variations is about to be developed. After developing the application-based algorithm, an efficient proof of concept (POC) will be carried out on one participant with ASD and CB. A focus group, including health professionals, will test the POC to identify the strengths and weaknesses of the developed system.ResultsHigher stress level is anticipated in the group of people with ASD looking at the disturbing video than in the typically developed peers. From the obtained data, the developed algorithm is used to predict CBs that are about to occur in the upcoming 1 min. A high level of satisfaction with the proposed technology and useful consideration for further developments are expected to emerge from the focus group.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT05340608].

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Pharmacotherapy of Autism and Related Disorders

Cited by 6 publications

References 37 publications

Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: A chart review study

Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: A chart review study

Aggression in autism spectrum disorder: presentation and treatment options

Development and validation of a system for the prediction of challenging behaviors of people with autism spectrum disorder based on a smart wearable shirt: A mixed-methods design

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