Randomised controlled trials of antipsychotics for people with autism spectrum disorder: a systematic review and a meta-analysis

Roy, Meera; Limbu, Bharati; Brizard, Basma Akrout; M.Murugan, M.Papakumari And; Roy, Ashok; Santambrogio, Jacopo

doi:10.1017/s003329172300212x

Cited by 5 publications

(2 citation statements)

References 35 publications

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“…Indeed, based on a recent systematic review and meta-analysis of antipsychotic medications in autism, there is some evidence for favorable effects of risperidone and aripiprazole on irritability and agitation in children with ASD. 47 However, we wish to underline that the use of pharmacotherapy should be resorted to only when there is a real need and, if possible, for limited periods of time.…”

Section: Treatments For Autism and Longterm Outcomementioning

confidence: 99%

Autism Spectrum Disorder in 2023: A Challenge Still Open

2023

Turk Arch Pediatrics

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In this paper, we provide an update on autism spectrum disorder (ASD), including epidemiology, etiopathogenesis, clinical presentation, instrumental investigations, early signs, onset patterns, neuropsychological hypotheses, treatments, and long-term outcome. The prevalence of this condition has increased enormously over the last few decades. This increase prompted a search for possible environmental factors whose effects would add up to a genetic predisposition leading to the development of autism. But the genetic and environmental variables involved are extremely numerous, and conclusive data regarding the etiopathogenesis are still far away. Assuming that a well-defined etiology is still found today only in a minority of cases, numerous pathogenetic mechanisms have been hypothesized. Among these, we mention oxidative stress, mitochondrial dysfunction, alteration of the intestinal microbiota, immune dysregulation, and neuroinflammation. These pathogenetic mechanisms could alter epigenetic status and gene expression, finally leading to ASD. Inherent in the term spectrum is the great clinical heterogeneity of this condition, mainly due to the frequent comorbidity that characterizes it. The earlier the diagnosis is made and the earlier psychoeducational treatment begins, the better the prognosis. In this sense, the role of pediatricians can be decisive in making children with signs suggestive of autism undergo a specialist diagnostic course. The development of increasingly advanced cognitive-behavioral educational techniques has considerably improved the prognosis of affected individuals, even though only a small minority of them come off the autistic spectrum. Pharmacological therapies are used to treat comorbidities. During childhood, the most important prognostic factor for long-term outcome seems to be intellectual functioning.

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Section: Treatments For Autism and Longterm Outcomementioning

confidence: 99%

Autism Spectrum Disorder in 2023: A Challenge Still Open

2023

Turk Arch Pediatrics

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“…Nonetheless, access to medication for children and adults mostly requires access to psychiatrists. While it can be beneficial for co-morbid conditions such as ADHD in children with autism, there are significantly increased risks of adverse effects and concerns around the long-term usage of anti-psychotics with children [20].…”

Section: Autism Adaptedmentioning

confidence: 99%

Nurturing the Positive Mental Health of Autistic Children, Adolescents and Adults alongside That of Their Family Care-Givers: A Review of Reviews

McConkey

2023

Brain Sciences

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The rising prevalence of autism internationally has been accompanied by an increased appreciation of the poorer mental health experienced by people with this condition and also of their family care-givers. In particular, higher incidences of anxiety and depression are reported in high-income nations and these conditions are likely to be under-recognised and under-reported in lower-resourced regions or countries. Mainstream mental health services seem to be ill-equipped to respond adequately to the needs of autistic persons and their care-givers. This literature review of 29 recently published reviews covering nearly 1000 journal articles summarises the insights and strategies that have been shown to promote the mental health and emotional wellbeing of autistic persons. In particular, a focus on family-centred, community-based supports is recommended that aim to enhance social communication, extend social connections and promote an individual’s self-esteem, self-determination and social motivation. These low-cost interventions are especially pertinent in low-resourced settings, but they can be used internationally to prevent mental illness and assist in the treatment of anxiety and depression in autistic persons and their family carers. The priority is to focus on primary-care responses with cross-sectoral working rather than investing in high-cost psychiatric provision.

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Ethical Prescribing of Psychotropic Medications for People with Neurodevelopmental Disorders

Deb,

Limbu,

Bianco

et al. 2023

Adv Neurodev Disord

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Objectives People with neurodevelopmental disorders (NDDs) such as intellectual and developmental disabilities (IDD) and autism are subjected to restrictive practices like physical restraint and the overuse of psychotropic medications for challenging behaviour in the absence of a psychiatric disorder. This practice may lead to human rights violations. Rational and evidence-based shared decision-making for person-centred planning will help reduce this practice. Methods We have discussed in this paper the issue of the overmedication of people with NDD, explaining how this practice may violate the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD). Results We have discussed how the following UN CRPD Articles may be affected by overmedication, including Article 15 (degrading treatment or punishment), 16 (abuse), 17 (the integrity of the person), and 25 (health). The other Articles that may be indirectly affected by this practice are 5 (equality and non-discrimination), 9 (accessibility), 19 (independent living and community inclusion), 21 (access to information), 24 (education), 26 (rehabilitation), 27 (work and employment), 28 (adequate living standard), and 30 (participation in recreation and leisure). Conclusions Overmedication of people with NDD, particularly the off-licence use of psychotropics for challenging behaviour, the side effects of these medications impacting the person’s quality of life are likely to violet several UN Articles on Rights of Persons with Disabilities. Following the right guidelines may help reduce these human rights violations.

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Randomised controlled trials of antipsychotics for people with autism spectrum disorder: a systematic review and a meta-analysis

Cited by 5 publications

References 35 publications

Autism Spectrum Disorder in 2023: A Challenge Still Open

Autism Spectrum Disorder in 2023: A Challenge Still Open

Nurturing the Positive Mental Health of Autistic Children, Adolescents and Adults alongside That of Their Family Care-Givers: A Review of Reviews

Ethical Prescribing of Psychotropic Medications for People with Neurodevelopmental Disorders

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