The pediatric psychopharmacology of autism spectrum disorder: A systematic review - Part I: The past and the present

Persico, Antonio M.; Ricciardello, Arianna; Lamberti, Marco; Turriziani, Laura; Cucinotta, Francesca; Brogna, Claudia; Vitiello, Benedetto; Arango, Celso

doi:10.1016/j.pnpbp.2021.110326

Cited by 63 publications

(46 citation statements)

References 237 publications

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“…Additionally, the choice of outcome measures can vary widely between studies, and there is sometimes question about whether or not a particular outcome measure is valid for measuring change in symptoms, or adequately captures the symptoms being targeted. See Persico et al (2021) for additional review of these medications.…”

Section: Traditional Psychotropic Medicationsmentioning

confidence: 99%

Decades of Progress in the Psychopharmacology of Autism Spectrum Disorder

Henneberry

Lamy

Dominick

et al. 2021

J Autism Dev Disord

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Recent decades have been marked by a wave drug treatment research in autism spectrum disorder (ASD). This work has resulted in improved ability to treat commonly occurring behavioral challenges associated with ASD including most prominently irritability marked by aggression, self-injurious behavior, and severe tantrums. While treatment of interfering behavior has progressed in our field, there remain several areas of unmet medical need including most prominently a lack of any approved drug therapies for the core, defining symptoms of autism. We outline the progress to date in the field of autism drug treatment while taking a future look forward into how decades of work can inform better future steps in this field.

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Section: Traditional Psychotropic Medicationsmentioning

confidence: 99%

Decades of Progress in the Psychopharmacology of Autism Spectrum Disorder

Henneberry

Lamy

Dominick

et al. 2021

J Autism Dev Disord

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“…Unfortunately, at present, there is no cure for autism. Patient symptomology and treatment goals often vary enormously, and interventions often include an individualized combination of behavioral and pharmacological interventions [ 24 , 25 ]. These interventions have shown some positive results in many individuals with ASD, but they rarely lead to significant improvements in the core symptoms of autism, i.e., deficits in social interactions and communication as well as restricted and repetitive interests and activities.…”

Section: Introductionmentioning

confidence: 99%

Cerebellar Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorder: A Pilot Study on Efficacy, Feasibility, Safety, and Unexpected Outcomes in Tic Disorder and Epilepsy

D’Urso

Toscano

Sanges

et al. 2021

JCM

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Patients with autism spectrum disorder (ASD) display distinctive neurophysiological characteristics associated with significant cognitive, emotional, and behavioral symptoms. Transcranial direct current stimulation (tDCS) applied to the frontal or temporoparietal lobes has demonstrated potential to reduce the severity of ASD-related symptoms. Recently, the cerebellum has been identified as a brain area involved in ASD pathophysiology. In this open-label pilot study, seven ASD patients aged between 9 and 13 years underwent 20 daily sessions of 20 min cathodal stimulation of the right cerebellar lobe. At the end of the treatment, the Aberrant Behavior Checklist (ABC) scores showed a 25% mean reduction in global severity of symptoms, with a more pronounced reduction in the “social withdrawal and lethargy” (−35%), “hyperactivity and noncompliance” (−26%), and “irritability, agitation, and crying” (−25%) subscales. Minor and no improvement were observed in the “stereotypic behavior” (−18%) and “inappropriate speech” (−0%) subscales, respectively. Improvements were not detected in the two patients who were taking psychotropic drugs during the study. Clinical response showed a symptom-specific time course. Quality of sleep and mood improved earlier than hyperactivity and social withdrawal. The treatment was generally accepted by patients and well tolerated. No serious adverse events were reported. Stimulation also appeared to markedly reduce the severity of tics in a patient with comorbid tic disorder and led to the disappearance of a frontal epileptogenic focus in another patient with a history of seizures. In conclusion, cerebellar tDCS is safe, feasible, and potentially effective in the treatment of ASD symptoms among children. Strategies to improve recruitment and retention are discussed.

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“…Regarding her medication regimen, we analyzed the risks and benefits particularly in the context of her rare genomic variant. She was already on aripiprazole, an antipsychotic medication that has an FDA indication for irritability in the setting of ASD, and which can also lead to weight gain, metabolic abnormalities, and decreased seizure threshold [3]. An EEG was obtained in the context of episodes of head tilting, repetitive picking, and decreased response to prompts, with her history of microcephaly and agenesis of the corpus callosum; it did not capture any clinical events, or evidence of seizure activity, diminishing our concern about this phenotype.…”

Section: Case Reportmentioning

confidence: 99%

Actionable Genomics in Clinical Practice: Paradigmatic Case Reports of Clinical and Therapeutic Strategies Based upon Genetic Testing

Butler

Moreno‐De‐Luca

Persico

2022

Genes

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In clinical settings, the information provided by genetic testing can explain the triggers and processes underlying clinical presentations, such as neurodevelopmental disorders, in up to one third of affected individuals. However, translating this knowledge into better and more personalized clinical management to many appears a distant target. This article presents three paradigmatic cases to exemplify how this translational effort can, at least in some instances, be undertaken today with very positive results: (a) a young girl carrying a chr. 16p11.2 duplication can be screened using targeted exams and undertake therapeutic/preventive interventions related to her genetic diagnosis; (b) a 13-year-old boy with intellectual disability and autism spectrum disorder carries a chr. 11q14.1 deletion, partly spanning the DLG2 gene important for synaptic function, and gained over 20 I.Q. points ostensibly due to carbolithium, prescribed in the absence of affective symptoms, exclusively following the pathophysiology pointed out by the genetic results; (c) a 58-year-old woman carries a COL3A1 gene variant responsible for the vascular form of Ehler–Danlos syndrome with colon rupture. Detection of this variant in six members of her extended family allows for better clinical management of the proband and targeted genetic counselling for family members at risk of this connective tissue disorder. The unprecedented flow of genetic information available today through new technologies, if interpreted in the light of current knowledge in clinical diagnosis and care of those with connective tissue disorders and neurodevelopmental disturbances, in biology and in neuropsychopharmacology, can promote better clinical and pharmacological treatment, disease surveillance, and management provided and incorporated into the clinical setting.

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The pediatric psychopharmacology of autism spectrum disorder: A systematic review - Part I: The past and the present

Cited by 63 publications

References 237 publications

Decades of Progress in the Psychopharmacology of Autism Spectrum Disorder

Decades of Progress in the Psychopharmacology of Autism Spectrum Disorder

Cerebellar Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorder: A Pilot Study on Efficacy, Feasibility, Safety, and Unexpected Outcomes in Tic Disorder and Epilepsy

Actionable Genomics in Clinical Practice: Paradigmatic Case Reports of Clinical and Therapeutic Strategies Based upon Genetic Testing

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