Tricyclic antidepressants for autism spectrum disorders (ASD) in children and adolescents

Hurwitz, Romy; Blackmore, Roger; Hazell, Philip; Williams, Katrina; Woolfenden, Susan

doi:10.1002/14651858.cd008372.pub2

Cited by 71 publications

(60 citation statements)

References 35 publications

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“…Another example is calcium channel genes, for example CaV1.2 , which were associated with multiple psychiatric disorders including autism and depression[37–39]. Interestingly, some antidepressants are effective for autistic symptoms[40]. It is certainly possible that an autistic model could express co-morbid depression and anxiety, given their shared genetic overlap.…”

Section: Discussionmentioning

confidence: 99%

Autism-related behavioral phenotypes in an inbred rat substrain

Zhang-James¹,

Li²,

Middleton³

et al. 2014

Behavioural Brain Research

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Behavioral and genetic differences among Wistar-Kyoto (WKY) rats from different vendors and different breeders have long been observed, but generally overlooked. In our prior work, we found that two closely related WKY substrains, the WKY/NCrl and WKY/NHsd rats, differ in a small percentage of their genome which appeared to be highly enriched for autism risk genes. Although both substrains have been used widely in studies of hypertension, attention deficit/hyperactivity disorder (ADHD) and depression, they have not been tested for any autism-related behavioral phenotypes. Furthermore, these two substrains have often been used interchangeably in previous studies; no study has systematically examined the phenotypic differences that could be attributed by their small yet potentially meaningful genetic differences. In this paper we compared these two substrains on a battery of neurobehavioral tests. Although two substrains were similar in locomotor activity, WKY/NCrl rats were significantly different from WKY/NHsd rats in the elevated plus maze test, as well as measures of social interaction and ultrasonic vocalization. These strains were also compared with Sprague Dawley (SD) rats, a common outbred strain, and spontaneous hypertensive rats (SHR), an inbred rat model for ADHD and hypertension, which were derived from the same ancestor strain as the WKY strains. Our behavioral findings suggest that WKY/NCrl rats may be useful as a model autism spectrum disorders due to their lower social interest, lower ultrasonic vocalization and higher anxiety levels when WKY/NHsd rats are used as the control strain. Given the small genetic difference between the two inbred substrains, future studies to identify the exact gene and sequence variants that differ between the two may be useful for identifying the genetic mechanisms underlying these behaviors.

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Section: Discussionmentioning

confidence: 99%

Autism-related behavioral phenotypes in an inbred rat substrain

Zhang-James¹,

Li²,

Middleton³

et al. 2014

Behavioural Brain Research

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“…Thus, we included 17 systematic reviews. 4,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Results from systematic reviews A summary of each systematic review is presented narratively below. In addition, Table 2 4,10-25 presents the issues addressed, the main findings from each systematic review and the quality of the evidence (based on the GRADE approach).…”

Section: Search Resultsmentioning

confidence: 99%

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?

et al. 2017

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CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs) include autistic disorder, Asperger's disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS:We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/ magnesium and SSRI for children. CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed. RESUMO MÉTODOS:Nós incluímos e resumimos os resultados de revisões sistemáticas Cochrane sobre intervenções para TEA. RESULTADOS: Foram incluídas 17 revisões que encontraram evidências fracas de benefícios da acupuntura, dietas isentas de glúten e caseína, intervenção comportamental intensiva precoce, musicoterapia, intervenção precoce mediada pelos pais, grupos de habilidades sociais, modelo cognitivo de Teoria da Mente, aripiprazol, risperidona, antidepressivos tricíclicos, inibidores seletivos da recaptação da serotonina (ISRS); o último apenas para adultos. Nenhum benefício foi encontrado com terapias sonoras, agentes quelantes, oxigenoterapia hiperbárica, ômega-3, secretina, vitamina B6/magnésio e ISRS para crianças. CONCLUSÃO: Acupuntura, dietas sem glúten e caseína, intervenção comportamental intensiva precoce, musicoterapia, intervenção precoce mediada pelos pais, grupos de habilidades sociais e modelo cognitivo de Teoria da Mente parecem ter benefícios para pacientes com TEA (evidência de qualidade muito baixa a baixa). Aripiprazol, risperidona, antidepressivos tricíclicos e ISRS (o último apenas para adultos) também apresentam algum benefício, embora estejam associados a maior risco de event...

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“…Despite this, prescribing practices in populations of youth with ASD indicates that the use of SSRIs is relatively common (e.g., Lopata et al 2013). Older medication classes such as tricyclic antidepressants are not recommended due to the lack of evidence supporting their use, as well as significant side effects (Hurwitz et al 2012). …”

Section: Pharmacologic Treatmentmentioning

confidence: 99%

ASD: Psychopharmacologic Treatments and Neurophysiologic Underpinnings

Kodish

Rockhill

2014

Electrophysiology and Psychophysiology in Psychiatry and Psychopharmacology

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Autism Spectrum Disorder encompasses a range of neurodevelopmental disorders characterized by early deficits in social communication in addition to restricted and repetitive behaviors. Symptoms are increasingly understood to be associated with abnormalities in the coordination of neuronal assemblies responsible for processing information essential for early adaptive behaviors. Pharmacologic treatments carry evidence for clinically significant benefit of multiple impairing symptoms of ASD, yet these benefits are limited and range across a broad spectrum of medication classes, making it difficult to characterize associated neurochemical impairments. Increasing prevalence of both ASD and its pharmacologic management calls for greater understanding of the neurophysiologic basis of the disorder. This paper reviews underlying alterations in local brain regions and coordination of brain activation patterns during both resting state and task-related processes. We propose that new pharmacologic treatments may focus on realigning trajectories of network specialization across development by working in combination with behavioral treatments to enhance social and emotional learning by bolstering the impact of experience-induced plasticity on neuronal network connectivity.

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Tricyclic antidepressants for autism spectrum disorders (ASD) in children and adolescents

Cited by 71 publications

References 35 publications

Autism-related behavioral phenotypes in an inbred rat substrain

Autism-related behavioral phenotypes in an inbred rat substrain

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?

ASD: Psychopharmacologic Treatments and Neurophysiologic Underpinnings

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