Pharmacotherapy of Autism Spectrum Disorders

Abstract

trum disorders (ASDs) over the past 2 decades. The most recent data suggest that 1 in 110 children and 1 in 70 male children will be diagnosed with an ASD. As the prevalence of ASDs has increased, so has the number of pharmacologic studies performed to address the associated interfering symptoms (ie, inattention/ hyperactivity, irritability/aggression, interfering repetitive and stereotypic behavior, and social deficits). This article discusses pharmacologic studies, which have attempted to address these symptoms and improve this population’s ability to function. HYPERACTIVITY AND INATTENTION Hyperactivity and inattention are frequently exhibited by individuals with ASDs. These are usually children who have difficulty staying focused without redirection and encounter problems staying seated in the same place for long periods of time. Even though these symptoms are common in individuals with ASDs, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), excludes the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in this population. There have been multiple studies with conflicting conclusions regarding the use of methylphenidate (MPH) in ASDs. Some studies suggest improvement in inattention and hyperactivity with MPH, whereas others report limited benefit and numerous adverse events. In one double-blind, placebo-controlled, crossover study, 10 children (ages 7–11 years) with ASDs were prescribed MPH (10 or 20 mg BID) or placebo. A small, statistically significant improvement in the MPH versus placebo group was captured on the Aberrant Behavior Checklist (ABC)-Hyperactivity Subscale (P 0.02) and Conners After participating in this CME activity, the psychiatrist should be better able to: • Choose the most effective medication for treatment of hyperactivity and inattention associated with autism spectrum disorders (ASDs). • Select firstand second-generation antipsychotics to treat irritability/aggression in patients with ASDs. • Assess the results of pharmacologic treatment for repetitive/stereotypic behaviors in patients with ASDs. • Evaluate the results of studies of memantine in patients with ASD who also have socialization issues.