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Pharmacotherapy in autism spectrum disorder

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Clinician’s Manual on Autism Spectrum Disorder

Abstract

ASD is a complex and heterogeneous disorder which is defined by the constellation of impairment in reciprocal social interactions, functional communication skills, and the presence of repetitive and restricted patterns of behavior and interests. Its etiology is still elusive, although a strong genetic component has been documented and gene-environment interactions have been hypothesized. Currently, only behavioral or psychosocial treatments have evidence of benefit for core symptom domains.

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References

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edn. Washington, D.C.: American Psychiatric Association; 2013.

    Google Scholar 

  2. Quintana H, Birmaher B, Stedge D, et al. Use of methylphenidate in the treatment of children with autistic disorder. J Autism Dev Disord. 1995;25:283-294.

    Google Scholar 

  3. Handen BL, Johnson CR, Lubetsky M. Efficacy of methylphenidate among children with autism and symptoms of attention-deficit hyperactivity disorder. J Autism Dev Disord. 2000;30:245-255.

    Google Scholar 

  4. Research Units on Pediatric Psychopharmacology Autism Network. Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Arch Gen Psychiatry. 2005;62:1266-1274.

    Google Scholar 

  5. Posey DJ, Aman MG, McCracken JT, et al. Positive effects of methylphenidate on inattention and hyperactivity in pervasive developmental disorders: an analysis of secondary measures. Biological Psychiatry. 2007;61:538-544.

    Google Scholar 

  6. Ghuman JK, Aman MG, Lecavalier L, et al. Randomized, placebo-controlled, crossover study of methylphenidate for attention-deficit/hyperactivity disorder symptoms in preschoolers with developmental disorders. J Child Adolesc Psychopharmacol. 2009;19:329-339.

    Google Scholar 

  7. Pearson DA, Santos CW, Aman MG, et al. Effects of extended release methylphenidate treatment on ratings of attention-deficit/hyperactivity disorder (ADHD) and associated behavior in children with autism spectrum disorders and ADHD symptoms. J Child Adolesc Psychopharmacol. 2013;23:337-351.

    Google Scholar 

  8. Reichow B, Volkmar FR, Bloch MH. Systematic review and meta-analysis of pharmacological treatment of the symptoms of attention-deficit/hyperactivity disorder in children with pervasive developmental disorders. J Autism Dev Disord. 2013;43:2435-2441.

    Google Scholar 

  9. Conners CK, Sitarenios G, Parker JD, Epstein JN. The Revised Conners’ Parent Rating Scale (CPRSR): factor structure, reliability, and criterion validity. J Abnorm Child Psychol. 1998;26:257-268.

    Google Scholar 

  10. Bussing R, Fernandez M, Harwood M, et al. Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample. Assessment. 2008;15:317-28.

    Google Scholar 

  11. Conners CK, Sitarenios G, Parker JD, Epstein JN. Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol. 1998;26:279-291.

    Google Scholar 

  12. Aman MG, Buican B, Arnold LE. Methylphenidate treatment in children with borderline IQ and mental retardation: analysis of three aggregated studies. J Child Adolesc Psychopharmacol. 2003;13:29-40.

    Google Scholar 

  13. Elia J, Borcherding BG, Rapoport JL, Keysor CS. Methylphenidate and dextroamphetamine treatments of hyperactivity: are there true nonresponders? Psychiatry Research. 1991;6:141-155.

    Google Scholar 

  14. Campbell M, Small AM, Collins PJ, Friedman E, David R, Genieser N. Levodopa and levoamphetamine: A crossover study in young schizophrenic children. Curr Ther Res Clin Exp. 1976;19:70-86.

    Google Scholar 

  15. Busner J, Targum SD, Miller DS. The Clinical Global Impressions scale: errors in understanding and use. Compr Psychiatry. 2009;50:257-262.

    Google Scholar 

  16. Mahajan R, Bernal MP, Panzer R, et al. Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders. Pediatrics. 2012; 130(Suppl 2):S125-S138.

    Google Scholar 

  17. Arnold LE, Aman MG, Cook AM, et al. Atomoxetine for hyperactivity in autism spectrum disorders: placebo-controlled crossover pilot trial. J Am Acad Child Adolesc Psychiatry. 2006; 45:1196-1205.

    Google Scholar 

  18. Harfterkamp M, van de Loo-Neus G, Minderaa RB, et al. A randomized double-blind study of atomoxetine versus placebo for attention-deficit/hyperactivity disorder symptoms in children with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2012;51:733-741.

    Google Scholar 

  19. Aman MG, Singh NN, Stewart AW, Field CJ. The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects. Am J Ment Defic. 1985;89:485-491.

    Google Scholar 

  20. Zhang S, Faries DE, Vowles M, Michelson D. ADHD Rating Scale IV: psychometric properties from a multinational study as a clinician-administered instrument. Int J Methods Psychiatr Res. 2005;14:186-201.

    Google Scholar 

  21. Kelsey DK, Sumner CR, Casat CD, et al. Once-daily atomoxetine treatment for children with attention-deficit/hyperactivity disorder, including an assessment of evening and morning behavior: a double-blind, placebo-controlled trial. Pediatrics. 2004;114:e1-e8.

    Google Scholar 

  22. Handen BL, Sahl R, Hardan AY. Guanfacine in children with autism and/or intellectual disabilities. J Dev Behav Pediatr. 2008;29:303-308.

    Google Scholar 

  23. Jaselskis CA, Cook EH, Jr., Fletcher KE, Leventhal BL. Clonidine treatment of hyperactive and impulsive children with autistic disorder. J Clin Psychopharmacol. 1992;12:322-327.

    Google Scholar 

  24. McCracken JT, McGough J, Shah B, et al. Risperidone in children with autism and serious behavioral problems. N Engl J Med. 2002;347:314-321.

    Google Scholar 

  25. Shea S, Turgay A, Carroll A, et al. Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics. 2004;114:e634-e641.

    Google Scholar 

  26. Nagaraj R, Singhi P, Malhi P. Risperidone in children with autism: randomized, placebocontrolled, double-blind study. J Child Neurol. 2006;21:450-455.

    Google Scholar 

  27. Pandina GJ, Bossie CA, Youssef E, Zhu Y, Dunbar F. Risperidone improves behavioral symptoms in children with autism in a randomized, double-blind, placebo-controlled trial. J Autism Dev Disord. 2007;37:367-373.

    Google Scholar 

  28. Owen R, Sikich L, Marcus RN, et al. Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. Pediatrics. 2009;124:1533-1540.

    Google Scholar 

  29. Marcus RN, Owen R, Kamen L, et al. A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. J Am Acad Child Adolesc Psychiatry. 2009;48:1110-1119.

    Google Scholar 

  30. Aman MG, Hollway JA, McDougle CJ, et al. Cognitive effects of risperidone in children with autism and irritable behavior. J Child Adolesc Psychopharmacol. 2008;18:227-236.

    Google Scholar 

  31. Barkley RA. The ecological validity of laboratory and analogue assessment methods of ADHD symptoms. J Abnorm Child Psychol. 1991;19:149-178.

    Google Scholar 

  32. Sharma A, Shaw SR. Efficacy of risperidone in managing maladaptive behaviors for children with autistic spectrum disorder: a meta-analysis. J Pediatr Health Care. 2012;26:291-299.

    Google Scholar 

  33. Anderson LT, Campbell M, Grega DM, Perry R, Small AM, Green WH. Haloperidol in the treatment of infantile autism: effects on learning and behavioral symptoms. Am J Psychiatry. 1984;141:1195-202.

    Google Scholar 

  34. Anderson LT, Campbell M, Adams P, Small AM, Perry R, Shell J. The effects of haloperidol on discrimination learning and behavioral symptoms in autistic children. J Autism Dev Disord. 1989;19:227-239.

    Google Scholar 

  35. McDougle CJ, Scahill L, Aman MG, et al. Risperidone for the core symptom domains of autism: results from the study by the autism network of the research units on pediatric psychopharmacology. Am J Psychiatry. 2005;162:1142-1148.

    Google Scholar 

  36. Ching H, Pringsheim T. Aripiprazole for autism spectrum disorders (ASD). Cochrane Database of Syst Rev. 2012(5):CD009043.

    Google Scholar 

  37. Jesner OS, Aref-Adib M, Coren E. Risperidone for autism spectrum disorder. Cochrane Database of Syst Rev. 2007(1):CD005040.

    Google Scholar 

  38. Hellings JA, Weckbaugh M, Nickel EJ, et al. A double-blind, placebo-controlled study of valproate for aggression in youth with pervasive developmental disorders. J Child Adolesc Psychopharmacol. 2005;15:682-692.

    Google Scholar 

  39. Hollander E, Chaplin W, Soorya L, et al. Divalproex sodium vs placebo for the treatment of irritability in children and adolescents with autism spectrum disorders. Neuropsychopharmacology. 2010;35:990-998.

    Google Scholar 

  40. Belsito KM, Law PA, Kirk KS, Landa RJ, Zimmerman AW. Lamotrigine therapy for autistic disorder: a randomized, double-blind, placebo-controlled trial. J Autism Dev Disord. 2001;31:175-181.

    Google Scholar 

  41. Wasserman S, Iyengar R, Chaplin WF, et al. Levetiracetam versus placebo in childhood and adolescent autism: a double-blind placebo-controlled study. Int Clin Psychopharmacol. 2006;21:363-367.

    Google Scholar 

  42. Campbell M, Anderson LT, Small AM, Adams P, Gonzalez NM, Ernst M. Naltrexone in autistic children: behavioral symptoms and attentional learning. J Am Acad Child Adolesc Psychiatry. 1993;32:1283-1291.

    Google Scholar 

  43. Willemsen-Swinkels SH, Buitelaar JK, Weijnen FG, van Engeland H. Placebo-controlled acute dosage naltrexone study in young autistic children. Psychiatry Res. 1995;58:203-215.

    Google Scholar 

  44. King BH, Wright DM, Handen BL, et al. Double-blind, placebo-controlled study of amantadine hydrochloride in the treatment of children with autistic disorder. J Am Acad Child Adolesc Psychiatry. 2001;40:658-665.

    Google Scholar 

  45. Remington G, Sloman L, Konstantareas M, Parker K, Gow R. Clomipramine versus haloperidol in the treatment of autistic disorder: a double-blind, placebo-controlled, crossover study. J Clin Psychopharmacol. 2001;21:440-444.

    Google Scholar 

  46. Boris M, Kaiser CC, Goldblatt A, et al. Effect of pioglitazone treatment on behavioral symptoms in autistic children. J Neuroinflammation. 2007;4:3.

    Google Scholar 

  47. Geier DA, Kern JK, Davis G, et al. A prospective double-blind, randomized clinical trial of levocarnitine to treat autism spectrum disorders. Med Sci Monit. 2011;17:PI15-PI23.

    Google Scholar 

  48. Akhondzadeh S, Fallah J, Mohammadi MR, et al. Double-blind placebo-controlled trial of pentoxifylline added to risperidone: effects on aberrant behavior in children with autism. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34:32-36.

    Google Scholar 

  49. Gordon CT, State RC, Nelson JE, Hamburger SD, Rapoport JL. A double-blind comparison of clomipramine, desipramine, and placebo in the treatment of autistic disorder. Arch Gen Psychiatry. 1993;50:441-447.

    Google Scholar 

  50. Hollander E, Phillips A, Chaplin W, et al. A placebo controlled crossover trial of liquid fluoxetine on repetitive behaviors in childhood and adolescent autism. Neuropsychopharmacology. 2005;30:582-589.

    Google Scholar 

  51. King BH, Hollander E, Sikich L, et al. Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism. Arch Gen Psychiatry. 2009;66:583-590.

    Google Scholar 

  52. McDougle CJ, Naylor ST, Cohen DJ, Volkmar FR, Heninger GR, Price LH. A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Arch Gen Psychiatry. 1996;53:1001-1008.

    Google Scholar 

  53. Asberg M, Montgomery SA, Perris C, Schalling D, Sedvall G. A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica Supplementum. 1978:5-27.

    Google Scholar 

  54. Williams K, Brignell A, Randall M, Silove N, Hazell P. Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2013;8:CD004677.

    Google Scholar 

  55. Scahill L, Riddle MA, McSwiggin-Hardin M, et al. Children’s Yale-Brown Obsessive Compulsive Scale: reliability and validity. J Am Acad Child Adolesc Psychiatry. 1997;36:844-852.

    Google Scholar 

  56. Hollander E, Soorya L, Chaplin W, et al. A double-blind placebo-controlled trial of fluoxetine for repetitive behaviors and global severity in adult autism spectrum disorders. Am J Psychiatry. 2012;169:292-299.

    Google Scholar 

  57. Aman MG, Kasper W, Manos G, et al. Line-item analysis of the Aberrant Behavior Checklist: results from two studies of aripiprazole in the treatment of irritability associated with autistic disorder. J Child Adolesc Psychopharmacol. 2010;20:415-422.

    Google Scholar 

  58. Rossignol DA, Frye RE. Melatonin in autism spectrum disorders: a systematic review and metaanalysis. Dev Med Child Neurol. 2011;53:783-792.

    Google Scholar 

  59. Rey JM, Hunt GE, Johnson GF. Assessment of tardive dyskinesia in psychiatric outpatients using a standardized rating scale. Aust N Z J Psychiatry. 1981;15:33-37.

    Google Scholar 

  60. Pringsheim T, Panagiotopoulos C, Davidson J, Ho J. Evidence-based recommendations for monitoring safety of second-generation antipsychotics in children and youth. Paediatr Child Health (Oxford). 2011;16:581-589.

    Google Scholar 

  61. Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children. (CAMESA). How to monitor antipsychotic drug safety. http://camesaguideline.org. Accessed January 4, 2015.

  62. Volkmar F, Siegel M, Woodbury-Smith M, King B, McCracken J, State M. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2014;53:237-257.

    Google Scholar 

  63. Huffman LC, Sutcliffe TL, Tanner IS, Feldman HM. Management of symptoms in children with autism spectrum disorders: a comprehensive review of pharmacologic and complementaryalternative medicine treatments. Journal of developmental and behavioral pediatrics. J Dev Behav Pediatr. 2011;32:56-68.

    Google Scholar 

  64. Akins RS, Angkustsiri K, Hansen RL. Complementary and alternative medicine in autism: an evidence-based approach to negotiating safe and efficacious interventions with families. Neurotherapeutics. 2010;7:307-319.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, ON, Canada

    Sharon Smile

  2. Autism Research Centre, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, ON, Canada

    Evdokia Anagnostou

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  1. Sharon Smile
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  2. Evdokia Anagnostou
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Editors and Affiliations

  1. Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Autism Research Centre, Toronto, Ontario, Canada

    Evdokia Anagnostou

  2. Holland Bloorview Kids Rehabilitation Hospital, University of Toronto,Autism Research Centre, Toronto, Ontario, Canada

    Jessica Brian

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Smile, S., Anagnostou, E. (2015). Pharmacotherapy in autism spectrum disorder. In: Anagnostou, E., Brian, J. (eds) Clinician’s Manual on Autism Spectrum Disorder. Adis, Cham. https://doi.org/10.1007/978-3-319-03056-2_5

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  • DOI: https://doi.org/10.1007/978-3-319-03056-2_5

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