Journal
BIOLOGICAL PSYCHIATRY
Volume 61, Issue 4, Pages 521-537Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2006.09.021
Keywords
autism; GABA; glutamate; neurodevelopment; serotonin; treatment
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Funding
- NICHD NIH HHS [T32 HD040127, T32-HD40127] Funding Source: Medline
- NIMH NIH HHS [1 K23 MH01802-01A2, 1 U54 MH66418, K23 MH001802, U54 MH066418] Funding Source: Medline
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Autism is a dynamic neurodevelopmental syndrome in which disabilities emerge during the first three postnatal years and continue to evolve with ongoing development. We briefly review research in autism describing subtle changes in molecules important in brain development and neurotransmission, in morphology of specific neurons, brain connections, and in brain size. We then provide a general schema of how these processes may interact with particular emphasis on neurotransmission. In this context, we present a rationale for utilizing pharmacologic treatments aimed at modifying key neurodevelopmental processes in young children with autism. Early treatment with selective serotonin reuptake inhibitors (SSRIs) is presented as a model for pharmacologic interventions because there is evidence in autistic children for reduced brain serotonin synthesis during Periods of peak synaptogenesis; serotonin is known to enhance synapse refinement; and exploratory studies with these agents in autistic children exist. Additional hypothetical developmental interventions and relevant publisbed clinical data are described. Finally, we discuss the importance of exploring early pharmacologic interventions within multiple experimental settings in order to develop effective treatments as quickly as possible minimizing risks.
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