Journal
CURRENT OPINION IN PSYCHIATRY
Volume 28, Issue 2, Pages 91-101Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/YCO.0000000000000132
Keywords
autism spectrum disorder; children and adolescents; drug therapy; pediatric; pharmacotherapy
Categories
Funding
- Alexza Pharmaceuticals
- American Academy of Child & Adolescent Psychiatry
- American Physician Institute
- American Psychiatric Press
- AstraZeneca
- Bracket
- Bristol-Myers Squibb
- Clinsys
- CogCubed
- Cognition Group
- Coronado Biosciences
- Dana Foundation
- Forest
- GlaxoSmithKline
- Guilford Press
- Johns Hopkins University Press
- Johnson Johnson
- KemPharm
- Lilly
- Lundbeck
- Merck
- NIH
- Novartis
- Noven
- Otsuka
- Oxford University Press
- Pfizer
- Physicians Postgraduate Press
- Rhodes Pharmaceuticals
- Roche
- Sage
- Seaside Pharmaceuticals
- Shire
- Stanley Medical Research Institute
- Sunovion
- Supernus Pharmaceuticals
- Transcept Pharmaceuticals
- Validus
- WebMD
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Purpose of review Although there is no known efficacious pharmacotherapy for core symptoms of autism spectrum disorder (ASD), psychotropic medications are commonly prescribed for behavioral/emotional symptoms associated with ASD. We reviewed current evidence-based pharmacotherapy options and updates from recent noteworthy studies. Recent findings Atypical antipsychotics, particularly risperidone and aripiprazole, are effective in reducing irritability, stereotypy and hyperactivity. Metabolic adverse events, including weight gain and dyslipidemia, are common. Methylphenidate is effective in reducing attention-deficit hyperactivity disorder (ADHD) symptoms. Atomoxetine and alpha-2 agonists appear effective in reducing ADHD symptoms. Selective serotonin reuptake inhibitors are not effective in improving repetitive behaviors in children with ASD, and frequently cause activating adverse events. Efficacy of antiepileptic drugs is inconclusive. Overall, efficacy and tolerability of pharmacotherapy in children with ASD are less favorable than data seen in typically developing children with similar symptoms. Newer agents, including glutamatergic agents and oxytocin, appear promising albeit with mixed results. Summary Current evidence-based pharmacotherapy options in children with ASD are very limited, and many have substantial adverse events. Clinicians should use pharmacotherapy as a part of comprehensive treatment, and judiciously weigh risks and benefits. New pharmacotherapy options for core symptoms as well as co-occurring symptoms of ASD are in urgent need.
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