Review of the pharmacotherapy of irritability of autism.

نویسندگان

  • Dean Elbe
  • Zaahira Lalani
چکیده

OBJECTIVE To review the randomized controlled trial data regarding pharmacotherapy of irritability of autism. METHOD A LITERATURE REVIEW WAS CONDUCTED USING THE MEDLINE SEARCH TERMS: 'autism' OR 'autism spectrum disorder' with the following limits: Randomized Controlled Trials (RCTs), human trials, English language. Additional articles were identified from reference information. Trials involving nutritional supplements, hormones or drugs not approved by either Health Canada or the US Food and Drug Administration (FDA) were excluded from analysis. RESULTS Twenty-three RCTs that met criteria were identified. The greatest number of RCTs involved risperidone, with six of seven placebo-controlled risperidone trials reporting statistically significant improvements on the primary outcome measure. Two aripiprazole RCTs and one olanzapine RCT reported statistically significant improvement in primary outcome measures. Haloperidol was superior to both clomipramine and placebo in a head-to-head crossover trial, while risperidone was superior to haloperidol for treatment of behavioural symptoms in a separate head-to-head trial. Clonidine, methylphenidate, valproate and levocarnitine monotherapy were superior to placebo in single RCTs, while adjunctive treatments cyproheptadine, pentoxifylline and topiramate were superior to placebo in small studies when given in combination with an antipsychotic. Adverse events from RCTs were summarized, including weight gain and metabolic effects, if available. CONCLUSION The bulk of positive RCT evidence for the pharmacotherapy of irritability of autism pertains to FDA approved antipsychotics risperidone and aripiprazole. RCTs supporting efficacy of several alternative and adjunctive agents may afford additional treatment options when optimal antipsychotic doses fail to control symptoms or cause intolerable adverse effects. Behavioural therapy should be employed where possible either before, or in addition to pharmacotherapy.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Efficacy and Tolerability of Pharmacotherapy Options for the Treatment of Irritability in Autistic Children

Children with autism have a high rate of irritability and aggressive symptoms. Irritability or self-injurious behavior can result in significant harm to those affected, as well as to marked distress for their families. This paper provides a literature review regarding the efficacy and tolerability of pharmacotherapy for the treatment of irritability in autistic children. Although antipsychotics...

متن کامل

Commentary on: "Review of the Pharmacotherapy of Irritability of Autism": A Skeptic's View on Second Generation Antipsychotics in Autism.

I “Review of the Pharmacotherapy of Irritability of Autism” (JCACAP, 21(2), 130-146), Elbe and Lalani provide a detailed review of available scientific literature on the psychopharmacologic treatment of Autism Spectrum Disorders (ASD). It is especially notable for its summary of the studies of second-generation antipsychotics (SGA). Given the current trends in SGA prescription in ASD, the autho...

متن کامل

Psychopharmacologic management of serious behavioral disturbance in ASD.

Individuals diagnosed with autism spectrum disorders (ASD) often exhibit serious behavioral disturbance (irritability) including severe tantrums, aggression, and self-injury that requires pharmacologic management. Research focused on the treatment of severe irritability has primarily involved the atypical antipsychotics, including risperidone and aripiprazole. Anticonvulsants have also been inv...

متن کامل

Bumetanide in Children and Adolescents with Autism ‎Spectrum Disorder

Introduction: Autism Spectrum Disorder (ASD) is characterized by several impairments in communications and social interactions as well as restricted interests or stereotyped behaviors. Interventions applied for this disorder are based on multi-modal approaches, including pharmacotherapy. No cure or medication has been introduced so far; therefore, there were studies investigating several drugs ...

متن کامل

Pharmacotherapy of emotional and behavioral symptoms associated with autism spectrum disorder in children and adolescents

Autism spectrum disorder (ASD) is characterized by impairment in social communication and restricted patterns of behavior. Although there is no pharmacological treatment approved by the US Food and Drug Administration (FDA) for the core symptoms of ASD, there is mounting support in the literature for the management of behavioral symptoms associated with this developmental disorder, in particula...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

دوره 21 2  شماره 

صفحات  -

تاریخ انتشار 2012