Abstract
“The promotion of maturation and development constitutes the essence of treatment of young, including psychotic children. Ideally, an effective drug should enhance this process” (Campbell, 1975, p. 399). It has been stated repeatedly, that the role of psychoactive agents in the treatment of autistic children is two-fold: to decrease behavioral symptoms and to promote development (Campbell, 1975). Pharmacotherapy should never be viewed as a sole treatment in autism; it is viewed only as part, however, sometimes an important part, of a comprehensive treatment program. Though there is some information about the type of symptoms which may respond to phannacotherapy (Perry et al., 1989a) clinical experience shows that the individual child with those very target symptoms may not respond to drug.
Keywords
Tardive Dyskinesia Adolescent Psychiatry Autistic Child Behavioral Symptom Infantile AutismPreview
Unable to display preview. Download preview PDF.
References
- Anderson, G. M., Minderaa, R B., Volkmar, F., & Cohen, D. J. Monoamines in autism. Abstracts. World Federation of Societies of Biological Psychiatry Regional Congress, Jerusalem, Israel, April 1989.Google Scholar
- Anderson, L. T., Campbell, M., Grega, D. M., Perry, R., Small, A. M., & Green, W. H. (1984). Haloperidol in the treatment of infantile autism: Effects on learning and behavioral symptoms. American Journal of Psychiatry, 141, 1195–1202.Google Scholar
- Anderson, L. T., Campbell, M., Adams, P., Small, A. M., Perry, R., & Shell, J. (1989). The effects of haloperidol on discrimination learning and behavioral symptoms in autistic children. Journal of Autism and Developmental Disorders, 19, 227–239.PubMedCrossRefGoogle Scholar
- August, G. J., Raz, N., & Baird, T. D. (1985). Brief report: Effects of fenfluramine on behavioral, cognitive and affective disturbances in autistic children. Journal of Autism, and Developmental Disorders, l5, 97–107.CrossRefGoogle Scholar
- Birmaher, B., Quintana, H., & Greenhill, L. L. (1988). Case study: Methylphenidate treatment of hyperactive autistic children. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 248–251.Google Scholar
- Campbell, M. (1975). Pharmacotherapy in early infantile autism. Biological Psychiatry, 10, 399–423.PubMedGoogle Scholar
- Campbell, M. (1978). The use of drug treatment in infantile autism and childhood schizophrenia: A review. In M. A. Lipton, A. Di Mascio & K. Killam (Eds.), Psychophannacology: A generation of progress (pp 1451–1461 ). New York: Raven Press.Google Scholar
- Campbell, M. (1985). Timed Stereotypies Rating Scale. Psychopharmacology Bulletin, Special Feature: Rating scales and assessment instruments for use in pediatric psychopharmacology research, 2/, 1082.Google Scholar
- Campbell, M. (1987). Drug treatment of infantile autism: The past decade. In H.Y. Meltzer (Ed.), Psychopharmacology: The Third Generation of Progress (pp 1225–1231 ). New York: Raven Press.Google Scholar
- Campbell, M. (1988). Fenfluramine treatment of autism. Annotation. Journal of Child Psychology and Psychiatry, 29, 1–10.PubMedCrossRefGoogle Scholar
- Campbell, M., & Palij, M. (1985a). Behavioral and cognitive measures used in psychopharmacological studies of infantile autism. Psychopharmacology Bulletin, 21, 1047–1053.PubMedGoogle Scholar
- Campbell, M., & Palij, M. (1985b). Measurement of side effects including tardive dyskinesia. Psychopharmacology Bulletin, 21, 1063–1066.PubMedGoogle Scholar
- Campbell, M., & Schopler, E. (Co-Chairpersons) (1989). Pervasive Developmental Disorders. In Treatments of Psychiatric Disorders. A Task Force Report of the American Psychiatric Association. T. B. Karasu, (Chairperson), Washington, DC: American Psychiatric Association, D. C. 1989, 1, 179, 294.Google Scholar
- Campbell, M., & Spencer, E. K. (1988). Psychopharmacology in child and adolescent psychiatry: A review of the last five years. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 269–279.PubMedCrossRefGoogle Scholar
- Campbell, M., Fish, B., David, R., Shapiro, T., Collins, P., & Koh, C. (1972). Response to Triiodothyronine and Dextroamphetamine: A study of preschool, schizophrenic children. Journal of Autism and Childhood Schizophrenia, 2, 343358.Google Scholar
- Campbell, M., Friedman, E., Green,W. H., Collins, P. J., Small, A. M., & Breuer, H. (1975). Blood serotonin in schizophrenic children. A preliminary study. International Pharmacopsychiatry, 10, 213–221.PubMedGoogle Scholar
- Campbell, M., Small, A. M., Collins, P. J., Friedman, E., David, R., & Genieser, N. (1976). Levodopa and levoamphetamine: A crossover study in young schizophrenic children. Current Therapeutic Research, 19, 70–86.Google Scholar
- Campbell, M., Andersson, L. T., Meier, M., Cohen, I. L., Small, A. M., Samit, C., & Sachar, E. J. (1978). A comparison of haloperidol, behavior therapy and their interaction in autistic children. Journal of the American Academy of Child and Adolescent Psychiatry, 17, 640–655.CrossRefGoogle Scholar
- Campbell, M., Anderson, L.T., Small, A M., Perry, R, Green, W. H., & Caplan, R. (1982). The effects of haloperidol on learning and behavior in autistic children. Journal of Autism and Developmental Disorders, 12, 167–175.Google Scholar
- Campbell, M., Cohen, I. L., & Small, A. M. (1982). Drugs in aggressive behavior. Journal of the American Academy of Child Psychiatry, 21, 107–117.Google Scholar
- Campbell, M., Grega, D. M., Green, W. H., & Bennett, W. G. (1983a). Neuroleptic- induced dyskinesias in children. Clinical Neuropharmacology, 6, 207–222.Google Scholar
- Campbell, M., Perry, R., Bennett, W. G., Small, A. M., Green, W. H., Grega, D., Schwartz, V., & Anderson, L. (1983b). Long-term therapeutic efficacy and drug-related abnormal movements: A prospective study of haloperidol in autistic children. Psychopharmacology Bulletin, 19, 80–83.Google Scholar
- Campbell, M., Adams, P., Perry, R, Spencer, E. K., & Overall, J. E. (1988a). Tardive and withdrawal dyskinesia in autistic children: A prospective study. Psychopharmacology Bulletin, 24, 251–255.PubMedGoogle Scholar
- Campbell, M., Adams, P., Small, A. M., Curren, E. L., Overall, J. E., Anderson, L. T., Lynch, N., & Perry, R (1988b). Efficacy and safety of fenfluramine in autistic children. Journal of the American Academy ofChild Psychiatry, 27, 434–439.CrossRefGoogle Scholar
- Campbell, M., Overall, J. E., Small., A. M., Sokol, M. S., Spencer, E. K., Adams, P., Foltz, R. L., Monti, K. M., Perry, R., Nobler, M., & Roberts, E. (1989). Naltrexone in autistic children: An acute open dose range tolerance trial. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 200–206.PubMedCrossRefGoogle Scholar
- Campbell, M., Anderson, L. T., Small, A. M., Locascio, J. J., Lynch, N. S., & Choroco, M. C. (1990). Naltrexone in autistic children: A double-blind and placebo controlled study. Psychophannacology Bulletin, 26,1 (in press).Google Scholar
- Cohen, D. J., Caparulo, B. K., Shaywitz, B. A., Bowers, M. B., Jr. (1977). Dopamine and serotonin metabolism in neuropsychiatric disturbed children. Archives of General Psychiatry, 34, 545–550.Google Scholar
- Cohen, I. L., Campbell, M., Posner, D., Small, A. M., Triebel, D., & Anderson, L. T. (1980). Behavioral effects of haloperidol in young autistic children. Journal of American Academy of Child Psychiatry, 19, 665–677.Google Scholar
- Deykin, E. Y., & MacMahon, B. (1979). The incidence of seizures among children with autistic symptoms. American Journal of Psychiatry, 136, 1310–1312.PubMedGoogle Scholar
- Ekman, G., Miranda-Linné, F., Gillberg, C., Garle, M., & Wetterberg, L. Fenfluramine treatment of 20 autistic children. Journal ofAutism and Developmental Disorders,1989 (in press).Google Scholar
- Engelhardt, D. M., & Polizos, P. (1978). Adverse effects of pharmacotherapy in childhood psychosis. In M. A. Lipton, A. di Mascio & K. F. Killam (Eds.), Psychopharmacology (pp 1463–1469 ). New York: Raven Press.Google Scholar
- Fish, B. Methodology in child psychopharmacology. In D. H. Efron, J. O. Cole, J. Levine & J. R Wittenborn (Eds.), Psychopharmacology, A Review of Progress, 1957–1967. Public Health Service Publication No. 1836. Washington, DC: US Government Printing Office, 1968, pp 989–1001.Google Scholar
- Fish, B., Shapiro, T., & Campbell, M. (1966). Long-term prognosis and the response of schizophrenic children to drug therapy: A controlled study of trifluoperazine. American Journal of Psychiatry, 123, 32–39.PubMedGoogle Scholar
- Geller, E., Ritvo, E. R, Freeman, B. J., & Yuwiler, A. (1982). Preliminary observations on the effects of fenfluramine on blood serotonin and symptoms in three autistic boys. New England Journal of Medicine, 307, 165–169.PubMedCrossRefGoogle Scholar
- Gillberg, C., & Svendsen, P. (1983). Childhood Psychosis and Computed Tomographic Brain Scan Findings. Journal of Autism and Developmental Disorders, 13 19–32.PubMedCrossRefGoogle Scholar
- Gillberg, C., Svennerholm, L., & Hamilton-Hellberg, C. (1983). Childhood psychosis and neuroamine metabolites in spinal fluid. Journal of Autism and Developmental Disorders, 13, 383–396.Google Scholar
- Gillberg, C., Terenius, L., & Lönnerholm, G. (1985). Endorphin activity in childhood psychosis: Spinal fluid level in 24 cases. Archives of General Psychiatry, 42, 780–783.PubMedCrossRefGoogle Scholar
- Golden, R. R, Campbell, M., & Perry, R (1987). A taxometric method for diagnosis of tardive dyskinesia. Journal of Psychiatric Research, 21, 233–241.PubMedCrossRefGoogle Scholar
- Greenhill, L. L., Solomon, M., Pleak R., & Ambrosini, P. Thioridazine versus Molindone in Conduct Disorder. Paper presented at the Symposium, Neuroleptics in Children: Efficacy and Side Effects, 140th Annual Meeting of the American Psychiatric Association, Chicago, IL, May 9–14, 1987.Google Scholar
- Herman, B. H., Hammock, M. K., Arthur-Smith, A., Egan, J., Chatoor, I., Zelnik, N., Appelgate, K., & Boeckx, R. L. Effects of naltrexone in autism: Correlation with plasma opioid concentrations. American Academy of Child and Adolescent Psychiatry, Scientific Proceedings for the Annual Meeting, (2), 11–12, 1986.Google Scholar
- Kalat, J. (1978). Speculation on the similarities between autism and opiate addiction. Journal of Autism and Childhood Schizophrenia, 8, 477–479.PubMedCrossRefGoogle Scholar
- Leboyer, M., Bouvard, M. P., & Dugas, M. (1988). Effects of naltrexone in infantile autism. Lancet, March 26, 715.CrossRefGoogle Scholar
- Leventhal, B. L. Fenfluramine administration to autistic children: Effects on behavior and biogenic amines. Paper presented at the 25th NCDEU Annual (Anniversary) Meeting, Key Biscayne, Florida, May 1–4, 1985.Google Scholar
- Meiselas, K. D., Spencer, E. K., Oberfield, R. A., Peselow, E. D., Angrist, B., & Campbell, M. (1989). Differentiation of stereotypies from neuroleptic-related dyskinesias in autistic children. Journal of Clinical Psychopharmacology, 7, 201–209.Google Scholar
- Minderaa, R. B., Anderson, G. M., Volkmar, F. R, Akkerhuis, G. W., & Cohen, D. J. (1989). Neurochemical study of dopamine functioning in autistic and normal subjects. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 190–194.PubMedCrossRefGoogle Scholar
- Naruse, H., Nagahata, M., Nakane, Y., Shirahashi, K., Takesada, M., & Yamazaki, K. (1982). A multicenter double-blind trial of pimozide (Orap), Haloperidol and placebo in children with behavior disorders, using crossover design. Acta Paedopsychiatrica, 48, 173–184.PubMedGoogle Scholar
- Panksepp, J. (1979). A neurochemical theory of autism. (TINS) Trends in Neuroscience, 2, 174–177.CrossRefGoogle Scholar
- Panksepp, J., & Sahley, T. L. (1987). Possible brain opioid involvement in disrupted social intent and language development in autism. In E. Schopler & G. B. Mesibov (Eds), Neurobiological Issues in Autism (pp. 357–372 ), New York: Plenum Press.Google Scholar
- Perry, R., Campbell, M., Green, W. H., Small, A. M., Die Trill, M. L., Meiselas, K., Golden, R. R., & Deutsch, S. I. (1985). Neuroleptic-related dyskinesias in autistic children: A prospective study. Psychopharmacology Bulletin, 21, 140143.Google Scholar
- Perry, R, Campbell, M., Adams, P., Lynch, N., Spencer, E. K., Curren, E. L., & Overall, J. E. (1989a). Long-term efficacy of haloperidol in autistic children: Continuous vs. discontinuous drug administration. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 87–92.PubMedCrossRefGoogle Scholar
- Perry, R, Nobler, M. S., & Campbell, M. (1989b). Case Report: Tourette-like symptoms associated with chronic neuroleptic therapy in an autistic child. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 93–96.Google Scholar
- Pickar, D., Vartanian, F., Bunney, W. E. Jr., Maier, H. P., Gastpan, M. T., Prakash, R., Sethi, B. B., Lideman, R, Belyaev, B. S., Tsatsulkovskaja, M. V. A. et al. (1982). Short-term naloxone administration in schizophrenic and manic patients. Archives of General Psychiatry, 39, 313–319.PubMedCrossRefGoogle Scholar
- Polizos, P., & Engelhardt, D. M. (1980). Dyskinetic and neurological complications in children treated with psychotropic medication. In W. E. Fann, R C. Smith, J. M. Davis & E. F. Domino (Eds.), TardiveDyskinesia. Research and Treatment (pp 193–199 ). Jamaica, NY: Spectrum Publications.Google Scholar
- Polizos, P., Engelhardt, D. M., Hoffman, S. P., & Waizer, J. (1973). Neurological consequences of psychotropic drug withdrawal in schizophrenic children. Journal of Autism and Childhood Schizophrenia, 3, 247–253.PubMedCrossRefGoogle Scholar
- Realmuto, G. M., August, G. J., & Garfinkel, B. D. (1989). Clinical effect of buspirone in autistic children. Journal of Clinical Psychopharmacology, 9, 122–125.PubMedCrossRefGoogle Scholar
- Ritvo, E. R, Yuwiler, A., Geller, E. M., Saeger, K., & Poltkin, S. (1970). Increased blood serotonin and platelets in early infantile autism. Archives of General Psychiatry, 566–572.Google Scholar
- Ritvo, E. R, Freeman, B. J., Geller, E., & Yuwiler, A. (1983). Effects of fenfluramine on 14 outpatients with the syndrome of autism. Journal of the American Academy of Child Psychiatry, 22, 549–558.PubMedCrossRefGoogle Scholar
- Ritvo, E. R., Freeman, B. J., Yuwiler, A., Geller, E., Yokota, A., Schroth, P., & Novak, P. (1984). Study of fenfluramine in outpatients with the syndrome of autism. Journal of Paediatrics, 105, 823–828.CrossRefGoogle Scholar
- Ritvo, E. R., Yuwiler, A., Geller, E., Schroth, P., Yokota, A., Mason-Brothers, A., August, G. J., Klykylo, W., Leventhal, B., Lewis, K., Piggott, L., Realmuto, G., Stubbs, E. G., & Umansky, R. (1986). Fenfluramine treatment of autism: UCLA collaborative study of 81 patients at nine medical centers. Psychopharmacology Bulletin, 22, 133–140.PubMedGoogle Scholar
- Sananman, M. L. (1974). Dyskinesia after fenfluramine. New England Journal of Medicine, 291, 422.PubMedGoogle Scholar
- Schuster, C. R., Lewis, M., & Seiden, L. S. (1986). Fenfluramine: Neurotoxicity. Psychopharmacology Bulletin, 22, 148–151.PubMedGoogle Scholar
- Shell, J., Spencer, E. K., Curren, E. L., Perry, R., Die Trill, M. L., Campbell, M., Lynch, N., & Polonsky, B. Long-term haloperidol administration and intellectual functioning in autistic children. Paper presented at the Annual Meeting of the American Academy of Child and Adolescent Psychiatry, Washington, D.C., October 21–25, 1987.Google Scholar
- Strayhorn, J. M. Jr., Rapp, N., Donina, W., & Strain, P. S. (1988). Randomized trial of methylphenidate for an autistic child. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 244–247.PubMedCrossRefGoogle Scholar
- Tarjan, C., Lowery, V. E., & Wright, S. W. (1957). Use of chlorpromazine in two hundred seventy-eight mentally deficient patients. A. M. A. Journal of Disturbed Children, 94, 294300.Google Scholar
- Walters, A. S., Barrett, R P., Feinstein, C., Mercurio, A., & Hole, W. The treatment of self-injury and social withdrawal in autism with naltrexone. Paper presented at the Eastern Psychological Association Meeting, Boston, MA, March 1989.Google Scholar
- Weizman, R., Weizman, A., Tyano, S., Szekely, G., Weizman, B. A., & Same, Y. (1984). Humoral-endorphin blood levels in autistic, schizophrenic and healthy subjects. Psychopharmacology, 82, 368–370.PubMedCrossRefGoogle Scholar
- Young, J. G., Kavanagh, M. E., Anderson, G. M., Shaywitz, B. A., & Cohen, D. J. (1982). Clinical neurochemistry of autism and associated disorders. Journal of Autism and Developmental Disorders, 12, 147–165.PubMedCrossRefGoogle Scholar