Article

Huffman LC, Sutcliffe TL, Tanner IS, et al. Management of symptoms in children with autism spectrum disorders: a comprehensive review of pharmacologic and complementary-alternative medicine treatments

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Journal of developmental and behavioral pediatrics: JDBP (Impact Factor: 2.12). 01/2011; 32(1):56-68. DOI: 10.1097/DBP.0b013e3182040acf
Source: PubMed

ABSTRACT In the care of children with autism spectrum disorders (ASD), medical treatment is typically considered an adjunct to educational and behavioral interventions. Nonetheless, large proportions of children with ASD are managed medically and receive both pharmacologic and complementary-alternative medicine (CAM) treatments. Although many medical treatments have been studied in children with ASD, studies vary widely in terms of the sample, sample size, research design, purposes of treatment, and measurements of change. Surprisingly, comprehensive reviews of the options for medical management in ASD are lacking, particularly reviews that address both pharmacologic and CAM treatments. Furthermore, reviews to date tend to emphasize general effects of medication; this perspective contradicts medical practice, which targets particular symptoms during treatment selection and monitoring. This review of 115 studies adds to the ASD treatment literature by (1) including studies of individuals 0 to 22 years of age; (2) aggregating studies of pharmacologic treatments and CAM treatments; and importantly, (3) organizing treatment response by ASD symptoms, differentiating core and associated symptoms.

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    • "Furthermore, some of the methods may be hardly applicable or less effective for individuals with limited intellectual functioning or severe autistic symptoms (Kenworthy et al., 2013; Matson & Smith, 2008). Thus, for many of those cases, especially when uncontrollable emotions or behaviors and severe inattention are involved, pharmacological interventions are considered for their beneficial effects on stabilizing mood and improving attention and behavioral problems (Huffman, Sutcliffe, Tanner, & Feldman, 2011). One study estimated that psychotropic drugs were prescribed to approximately 30% of the ASD cohort, and polypharmacy was observed in one-third of the prescribed individuals (Murray et al., 2013). "
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    • "Similar to behavioral interventions, there is little biological evidence to specifically support these treatments. Also, the safety profile and efficacy of these treatments in children with ASD remain to be further investigated (Panagiotopoulos et al., 2010; Huffman et al., 2011). "
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    • "Irritability , marked by severe tantrums, aggression and selfinjury , is common and impairing, but not a core deficit of the disorder.(McPheeters et al. 2011; Huffman et al. 2011) The use of these atypical antipsychotics targeting irritability associated with autistic disorder was based on empirical extension of their effects in other disorders and previous reports on use of typical (older generation) antipsychotics in ASD, rather than specifically on a neurobiological understanding of the pathophysiology of ASD. "
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