A Systematic Review of Medical Treatments for Children With Autism Spectrum Disorders

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PEDIATRICS (Impact Factor: 5.47). 04/2011; 127(5):e1312-21. DOI: 10.1542/peds.2011-0427
Source: PubMed


As many as 1 in every 110 children in the United States has an autism spectrum disorder (ASD). Many medical treatments for ASDs have been proposed and studied, but there is currently no consensus regarding which interventions are most effective.
To systematically review evidence regarding medical treatments for children aged 12 years and younger with ASDs.
We searched the Medline, PsycInfo, and ERIC (Education Resources Information Center) databases from 2000 to May 2010, regulatory data for approved medications, and reference lists of included articles. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Studies of secretin were not included in this review. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of-evidence ratings on the basis of predetermined criteria.
Evidence supports the benefit of risperidone and aripiprazole for challenging and repetitive behaviors in children with ASDs. Evidence also supports significant adverse effects of these medications. Insufficient strength of evidence is present to evaluate the benefits or adverse effects for any other medical treatments for ASDs, including serotonin-reuptake inhibitors and stimulant medications.
Although many children with ASDs are currently treated with medical interventions, strikingly little evidence exists to support benefit for most treatments. Risperidone and aripiprazole have shown benefit for challenging and repetitive behaviors, but associated adverse effects limit their use to patients with severe impairment or risk of injury.

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    • "ical and SHH levels which created a negative feedback response ( Al - Ayadhi , 2012 ) . A large proportion of ASD patients , including very young chil - dren , are prescribed psychoactive drugs such as antidepressants and antipsychotics ( Mandell et al . , 2008 ; Oswald and Sonenklar , 2007 ) despite lack of scientific evidence of their efficacy ( McPheeters et al . , 2011 ) . Antipsychotic drugs , especially the FDA - approved atypical antipsychotic risperidone , are prescribed to combat symptoms like irritability and aggression ( McDougle et al . , 1998 ; Posey et al . , 2008 ) . Importantly , risperidone is the first drug approved for the use in autism and the first atypical antipsychotic drug approved"
    X Du · R.A. Hill ·
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    ABSTRACT: Neurodevelopmental disorders are a group of conditions that arises from impairments of the central nervous system during its development. The causes of the various disorders are heterogeneous and the symptoms likewise are multifarious. Most of these disorders currently have very little available treatment that is effective in combating the plethora of serious symptoms. Brain-derived neurotrophic factor (BDNF) is a fundamental neurotrophin with vital functions during brain development. Pre-clinical studies have shown that increasing BDNF signalling may be a potent way to prevent, arrest or even reverse abnormal neurodevelopmental events arising from a variety of genetic or environmental causes. However, many difficulties make BDNF problematic to administer in an efficient manner. The recent discovery of a small BDNF-mimetic, the naturally occurring flavonoid 7,8-dihydroxyflavone (7,8-DHF), may provide an avenue to allow efficient and safe activation of the BDNF pathway in tackling the symptoms of neurodevelopmental disorders. Here, evidence will be provided to support the potential of 7,8-DHF as a novel treatment for several neurodevelopmental disorders where the BDNF signalling pathway is implicated in the pathophysiology and where benefits are therefore most likely to be derived from its implementation. Copyright © 2015. Published by Elsevier Ltd.
    Neurochemistry International 07/2015; 89. DOI:10.1016/j.neuint.2015.07.021 · 3.09 Impact Factor
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    • "lopmental level ( American Psychiatric Association , 2013 ) . Although there is clearly a genetic basis to ASD , the majority of cases have unknown causes ( Abrahams and Geschwind , 2008 ; Geschwind , 2008 ) . It is , moreover , now widely accepted that ASD is a neurobiological disorder , but specific biological markers are yet to be established ( McPheeters et al . , 2011 ; Warren et al . , 2011 ) . Magnetic resonance spectroscopy ( MRS ) has made it possible to study the concentration of biochemical substances in the healthy and diseased brain ( Soares and Law , 2009 ) . By measuring from a volume element ( MRS voxel ) in specific regions of interest , metabolite concentrations can be estimated due to d"
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    ABSTRACT: Magnetic resonance spectroscopy (MRS) from voxels placed in the left anterior cingulate cortex (ACC) was measured from 14 boys with Autism Spectrum Disorder (ASD) and 24 gender and age-matched typically developing (TD) control group. Our main aims were to compare the concentration of γ-aminobutyric acid (GABA) between the two groups, and to investigate the relationship between brain metabolites and autism symptom severity in the ASD group. We did find a significant negative correlation in the ASD group between Autism Spectrum Screening Questionnaire (ASSQ) and GABA+/Cr, which may imply that severity of symptoms in ASD is associated with differences in the level of GABA in the brain, supporting the excitatory/inhibitory (E/I) imbalance theory. However we did not find a significant difference between the two groups in GABA levels.
    Frontiers in Human Neuroscience 06/2015; 9:365. DOI:10.3389/fnhum.2015.00365 · 3.63 Impact Factor
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    • "Despite insufficient evidence on the efficacy and longterm safety of psychotropic drugs for ASD treatment, various medications have been used for ASD comorbidity treatment in clinical practice such as α-adrenergic agents, β-blockers, mood stabilizers, antiepileptic medication, and antipsychotics [Hollander, Phillips, & Yeh, 2003; McPheeters et al., 2011; Myers et al., 2007; Rosenberg et al., 2010]. "
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    ABSTRACT: There is significant variation in prescriptions among countries in clinical practice for the treatment of comorbidities associated with autism spectrum disorder (ASD). It has been suggested that many people with mental health disorders in low-/middle-income countries do not receive adequate treatment. Hence, this study investigated psychopharmacological treatment patterns for ASD comorbidities in 30 countries and the association between country's income and prescription rates.The IMS Prescribing Insights database was used to investigate prescription patterns for ASD comorbidity treatment from 2007 to 2012. Data were obtained from 30 countries in continents of Europe, Asia, Oceania, Central America, South America, and Africa. The gross domestic product (GDP) per capita was used as a proxy for each country's income. Spearman correlation was used to examine the association between prescription rate and GDP per capita.The highest prescription rates were found in Western Europe (3.89–36.36/10,000) while the lowest prescription rates were found in Asian countries, such as Turkey, Indonesia, Saudi Arabia, and Pakistan (0.04–0.82/10,000). The most commonly prescribed drug for ASD comorbidity treatment in most of the countries was risperidone, but antidepressants and antiepileptic drugs were also frequently prescribed. There was a significant positive correlation between GDP per capita and prescription rate (Spearman ρ = 0.60; P = 0.0011; 95% confidence interval 0.27–0.81), that is, the higher the GDP per capita, the higher the prescription rate.There are marked international differences in prescription rates, and this is partially accounted by economic factors. Future research should combine more data for ASD comorbidity treatment to explore the disparity of psychopharmacological treatment between countries. Autism Res 2014, ●●: ●●–●●. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.
    Autism Research 10/2014; 7(5). DOI:10.1002/aur.1391 · 4.33 Impact Factor
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