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

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PEDIATRICS (Impact Factor: 5.3). 04/2011; 127(5):e1312-21. DOI: 10.1542/peds.2011-0427
Source: PubMed

ABSTRACT 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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    • "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 · 2.90 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 · 4.53 Impact Factor
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    • "Although there is a marked lack of data on the use of medication treatments for adolescents and young adults with ASD (Dove et al. 2012), a common conceptualization held by many parents is that the more treatments used the better, which has led to many unsubstantiated ASD treatments (Matson et al. 2013). McPheeters et al. (2011) also reported that although many of the children with ASDs are currently treated with medical interventions, strikingly little evidence exists to support the benefit of most of these treatments. Consequently, children with parent-reported ASD had higher levels of health care office visits and prescription drug use compared with children without ASD (Lavelle et al. 2014). "
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    ABSTRACT: This paper aims to examine health care utilization and expenditure in the provision of medical care to understand the medical care burden of children with autism spectrum disorders based on recent literature reviews. This article reviews the recent literature in Medline, PubMed, and Google by using key terms that are relevant to autism spectrum disorder (ASD) and health care (medical care) utilization, medical care costs, and expenditures. I also hand-searched the reference lists of all of the included articles and recent narrative and systematic reviews related to medical care utilization and the costs of ASD to identify potentially relevant articles. The literature on medical care utilization and expenditures related to ASD highlights the fact that the disorder imposes high medical care burdens on families and on society. It is necessary to initiate appropriate, comprehensive, and accessible medical care services for individuals with ASD, particularly for those with comorbid conditions. Future studies should examine the impact of such improvements in the management of children with ASD on medical care utilization and costs.
    06/2014; 1(3). DOI:10.1007/s40489-014-0023-8
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