Pharmacotherapy to control behavioral symptoms in children with autism.
Author(s): Doyle CA, McDougle CJ.
Affiliation(s): Indiana University School of Medicine and Christian Sarkine Autism Treatment
Center, Riley Hospital for Children, Department of Psychiatry, IN, USA.
Publication date & source: 2012, Expert Opin Pharmacother. , 13(11):1615-29
INTRODUCTION: Autistic disorder, Asperger's disorder, and pervasive developmental
disorder not otherwise specified (PDD-NOS) are pervasive developmental disorders
(PDDs) frequently associated with behavioral symptoms that may require
pharmacotherapy to manage. AREAS COVERED: Behavioral symptoms in children with
autism include interfering repetitive behaviors, irritability, and hyperactivity
and inattention, among others. The psychotropic medications examined in this
review include: serotonin reuptake inhibitors, typical and atypical
antipsychotics, medications used to treat attention-deficit/hyperactivity
disorder, naltrexone, buspirone, divalproex sodium, lamotrigine, levetiracetam,
memantine, mirtazapine, riluzole, pioglitazone, and topiramate. EXPERT OPINION:
For the treatment of interfering repetitive behaviors, serotonin reuptake
inhibitors demonstrate less efficacy and are more poorly tolerated in children
with autism compared to adults. Antipsychotics are the most efficacious drugs for
the treatment of irritability in children with autism and other PDDs. For the
treatment of hyperactivity and inattention, psychostimulants demonstrate some
benefit. However, they are overall less efficacious and cause more side effects
in children with PDDs compared to typically developing children with
attention-deficit/hyperactivity disorder. Results from double-blind,
placebo-controlled trials of these agents and others for the treatment of the
behavioral symptom domains described above will be discussed in this review.
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