ASD: Psychopharmacologic Treatments and Neurophysiologic Underpinnings

Kodish, Ian; Rockhill, Carol

doi:10.1007/7854_2014_298

Cited by 3 publications

(4 citation statements)

References 121 publications

(124 reference statements)

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“…The clinical impairments associated with ASD are often difficult to alleviate, and are increasingly managed using pharmacologic interventions. While core symptoms of communication deficits and circumscribed interests are difficult to address with medication, other clinical impairments are often targets of treatment, including comorbid anxiety, difficulty with sustained attention, aggressive behaviors, sleep disturbances, and stereotypic movements [for review see 175,192,193].…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

“…The effectiveness of risperidone and aripripazole for irritability associated with autism is supported by several articles reviewing the literature. All conclude that the data supporting effectiveness is strong, while cautioning that behavioral intervention should be tried first, and that side effects including metabolic abnormalities, weight gain, and potential for extrapyramidal side effects warrant caution in their use [192].…”

Section: Antipsychotic Medicationsmentioning

confidence: 99%

“…One RCT of amantadine treatment in youth with ASD found improved control of irritability and hyperactivity [210], and another reported beneficial effects for ADHD [211]. Although amantadine is not commonly used, it may be considered when other treatments do not provide adequate symptom control, particularly for distractibility and hyperactivity [192].…”

Section: Nonstimulant Medicationsmentioning

confidence: 99%

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The Comorbidity of ADHD and Autism Spectrum Disorders (ASDs) in Community Preschoolers

Carrascosa-Romero¹,

Cabo²

2015

ADHD - New Directions in Diagnosis and Treatment

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Symptoms of inattention and hyperactivity, features of attention-deficit/hyperactivity disorder (ADHD), have been frequently documented in children with autism spectrum disorders (ASDs) and often co-occur. Evidence indicates that 20-50% of children with ADHD meet criteria for ASD, and 30-80% of ASD children meet criteria for ADHD. According to the DSM-IV, the essential features of Autistic Disorder (AD) are "the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interests". Differential diagnosis of "Pervasive Developmental Disorder" (PDD: Autistic Disorder, Rett's Disorder, Childhood Disintegrative Disorder, Asperger's Disorder) and "Pervasive Developmental Disorder-Not Otherwise Specified"(PDD-NOS) is often difficult in the preschool child. This is particularly true when assessing verbal and nonverbal communication since both expressive and cognitive language are not yet established and there are many differences in their acquisition period among these children (before the age of three). As a result, many of these children are diagnosed with PDD-NOS not meeting the criteria for a specific type of PDD; this category includes "atypical autism" presentations that do not meet the criteria for AD. As a result, the concept of PDD-NOS has become a mixed bag. Often, diagnosis cannot be established before age three, delaying therapeutic interventions. Moreover, differential diagnosis between ADHD and PDD-NOS can be especially difficult, mainly in infant and young children. However, and following the recommendations of the DSM-IV, the ASDs diagnosis has been included among the exclusion criteria for the ADHD. Such exclusion has generated considerable controversy regarding the necessity and benefits of maintaining these separations. At present, a new edition of the DSM has been published: DSM-5® (Fifth Edition, 2013). Among the advantages that this new manual provides are: i) further categorization of the persons affected and ii) the possibility of diagnosis before the age of three. The DSM-5 takes into account that limitations in language are not specific to autism. The new diagnostic category "Social Communication Disorder" appears separate from ASD, which does not seek to create a new subcategory.

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Section: Pharmacological Interventionsmentioning

confidence: 99%

Section: Antipsychotic Medicationsmentioning

confidence: 99%

Section: Nonstimulant Medicationsmentioning

confidence: 99%

See 1 more Smart Citation

The Comorbidity of ADHD and Autism Spectrum Disorders (ASDs) in Community Preschoolers

Carrascosa-Romero¹,

Cabo²

2015

ADHD - New Directions in Diagnosis and Treatment

View full text Add to dashboard Cite

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“…Psychological symptoms such as irritability, aggressive behaviours, depression and anxiety as well as physical symptoms such as sleep and gastrointestinal disturbances can be caused by comorbidities that often accompany a diagnosis of ASD. These symptoms are often treated with medications with variable effectiveness, often introducing undesirable side effects (9). As a result, children with ASD are treated with polypharmacy regimens often off-label.…”

Section: Introductionmentioning

confidence: 99%

Treating Children with ASD: The Perspective of Caregivers

et al. 2018

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-Purpose: Treatment of Autism Spectrum Disorders (ASD) is challenging. Parents/caregivers' perspective on the effectiveness of therapies and services available to their children is important but neglected in the literature on ASD. This study investigated such perspective through questionnaire-guided interviews with a group of parents in the province of Manitoba (Canada). A secondary objective of the study was to explore how health care professionals and specifically pharmacists can assist in providing better care to children with ASD. Methods: Informed consent was obtained from all participants. Data on diagnoses and prescribed medications were collected from medical charts. Parents/caregivers completed questionnaires during interviews scheduled at their convenience. Specific questions were asked to gather caregivers/parents' perspectives on the effectiveness of medications and non-pharmacological interventions in controlling symptoms experienced by their children. Information on access to education and health services was also assessed. Common themes were identified using thematic analysis. Results: All children attended school, 88% were males, 50% experienced eating/sleeping difficulties; 69% reported Attention Deficit Hyperactivity Disorder comorbidity. Risperidone was reported to be effective in controlling aggressive behaviours. Methylphenidate and aripiprazole were often discontinued. Melatonin and occupational therapy services were said to be very useful. Access to behavioural therapy was often limited. Parents were concerned about lack of trained professionals in schools, limited understanding of their children's needs, and uncertainty for the future. Conclusions: Better education and awareness are necessary to help ASD children and their families. Pharmacists should explore opportunities to provide better services.

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Psychotropic Medication Use in Autism Spectrum Disorders May Affect Functional Brain Connectivity

Linke

Olson

Gao

et al. 2017

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

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Background Prescription of psychotropic medications is common in autism spectrum disorders (ASDs), either off-label or to treat comorbid conditions such as ADHD or depression. Psychotropic medications are intended to alter brain function. Yet, studies investigating the functional brain organization in ASDs rarely take medication usage into account. This could explain some of the inconsistent findings of atypical brain network connectivity reported in the autism literature. Methods The current study tested whether functional connectivity patterns, as assessed with functional magnetic resonance imaging (fMRI), differed in a cohort of 49 children and adolescents with ASDs based on psychotropic medication status, and in comparison with 50 matched typically developing (TD) participants. Twenty-five participants in the ASD group (51%) reported current psychotropic medication usage, including stimulants, antidepressants, antipsychotics, and anxiolytics. Age, IQ, head motion, and ASD symptom severity did not differ between groups. Whole-brain functional connectivity between 132 regions of interest was assessed. Results Different functional connectivity patterns were identified in the ASD group taking psychotropic medications (ASD-on), as compared to the TD group and the ASD subgroup not using psychotropic medications (ASD-none). The ASD-on group showed distinct underconnectivity between the cerebellum and basal ganglia but cortico-cortical overconnectivity compared to the TD group. Cortical underconnectivity relative to the TD pattern, on the other hand, was pronounced in the ASD-none group. Conclusions These results suggest that psychotropic medications may affect functional connectivity, and that medication status should be taken into consideration when studying brain function in autism.

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ASD: Psychopharmacologic Treatments and Neurophysiologic Underpinnings

Cited by 3 publications

References 121 publications

The Comorbidity of ADHD and Autism Spectrum Disorders (ASDs) in Community Preschoolers

The Comorbidity of ADHD and Autism Spectrum Disorders (ASDs) in Community Preschoolers

Treating Children with ASD: The Perspective of Caregivers

Psychotropic Medication Use in Autism Spectrum Disorders May Affect Functional Brain Connectivity

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