Child, Parent, and Service Predictors of Psychotropic Polypharmacy Among Adolescents and Young Adults with an Autism Spectrum Disorder

Lake, Johanna K.; Weiss, Jonathan A.; Dergal, Julie; Lunsky, Yona

doi:10.1089/cap.2014.0011

Cited by 18 publications

(16 citation statements)

References 55 publications

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“… 6 In addition, some of the websites promoted the use of non-medical and biomedical interventions simultaneously, which is in line with evidence supporting their effectiveness when used concurrently. 10 However, other websites recommended the use of only one ASD intervention that had little to no support, including cultural and religious treatments (e.g., visiting a religious healer, goat milk, honey) or only medical and related interventions (e.g.., chelation therapy, hyperbaric oxygen therapy). This could potentially lead to the acquisition of erroneous information and, even worse, the implementation of therapies that are not evidence-based or that might even be harmful.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Arabic Websites with information on autism

Alnemary

Alamri

2017

NSJ

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Objectives:To explore the characteristics of Arabic websites with information on autism spectrum disorder (ASD).Methods:The word autism in Arabic was entered into 2 popular search engines in September 2013 to locate the top 80 websites featuring the term. Websites were sorted using 10 characteristics, previously used to evaluate the characteristics of English websites with information on ASD.Results:Most websites were registered using a.com top-level domain (69%), were an individual’s site, forum, or blog (44%), and were updated after September 2012 (60%); they contained images or texts that seemed to persuade viewers to purchase products (43%); they provided information with the name of author(s) (64%); they described the basic characteristics of ASD; and they promoted various types of treatments, most of which lack empirical support (63%). However, few websites contained information with references to peer review resources (3%) or a warning statement that such information should not replace the opinion of a qualified professional (8%).Conclusion:Internet users may not find Arabic websites to be reliable sources to obtain information on ASD. Given the increased use of the internet, creation of websites that contain trusted information on ASD could potentially aid parents in accessing available services, help them learn about empirically validated interventions, and enable them to advocate for their children’s rights.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Arabic Websites with information on autism

Alnemary

Alamri

2017

NSJ

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“… 174 , 175 In fact, recent studies have questioned the benefit of psychotropic agents and have highlighted frequent adverse effects such as weight gain, sedation, tremor, movement disorders and drooling. 176 As a result, there is increased polypharmacy 174 , 177 and risk of unwanted drug interactions. 178 …”

Section: Treatment Approachesmentioning

confidence: 99%

Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders

et al. 2016

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Autism spectrum disorders (ASDs) affect as many as 1 in 45 children and are characterized by deficits in sociability and communication, as well as stereotypic movements. Many children also show severe anxiety. The lack of distinct pathogenesis and reliable biomarkers hampers the development of effective treatments. As a result, most children with ASD are prescribed psychopharmacologic agents that do not address the core symptoms of ASD. Autoantibodies against brain epitopes in mothers of children with ASD and many such children strongly correlate with allergic symptoms and indicate an aberrant immune response, as well as disruption of the blood–brain barrier (BBB). Recent epidemiological studies have shown a strong statistical correlation between risk for ASD and either maternal or infantile atopic diseases, such as asthma, eczema, food allergies and food intolerance, all of which involve activation of mast cells (MCs). These unique tissue immune cells are located perivascularly in all tissues, including the thalamus and hypothalamus, which regulate emotions. MC-derived inflammatory and vasoactive mediators increase BBB permeability. Expression of the inflammatory molecules interleukin (IL-1β), IL-6, 1 L-17 and tumor necrosis factor (TNF) is increased in the brain, cerebrospinal fluid and serum of some patients with ASD, while NF-kB is activated in brain samples and stimulated peripheral blood immune cells of other patients; however, these molecules are not specific. Instead the peptide neurotensin is uniquely elevated in the serum of children with ASD, as is corticotropin-releasing hormone, secreted from the hypothalamus under stress. Both peptides trigger MC to release IL-6 and TNF, which in turn, stimulate microglia proliferation and activation, leading to disruption of neuronal connectivity. MC-derived IL-6 and TGFβ induce maturation of Th17 cells and MCs also secrete IL-17, which is increased in ASD. Serum IL-6 and TNF may define an ASD subgroup that benefits most from treatment with the natural flavonoid luteolin. Atopic diseases may create a phenotype susceptible to ASD and formulations targeting focal inflammation of the brain could have great promise in the treatment of ASD.

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“…There is an abundance of research regarding polypharmacy and the use of psychotropic medications in patients with ASD ( Table 1 ). 17 – 25 Parent/guardian surveys and retrospective reviews of insurance databases have shown an increase in the use of psychotropic medications over the years. The only medications approved for the treatment of ASD by the FDA are risperidone and aripiprazole, both of which are indicated for treating irritability or aggression in patients.…”

Section: Polypharmacy In Asd and Psychiatric Disordersmentioning

confidence: 99%

Polypharmacy in pediatric patients and opportunities for pharmacists' involvement

Horace¹,

Ahmed²

2015

IPRP

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Rates of chronic conditions among pediatrics have been steadily increasing and medications used to treat these conditions have also shown a proportional increase. Most clinical trials focus on the safety of solitary medications in adult patients. However, data from these trials are often times extrapolated for use in pediatric patients who have different pharmacokinetic processes and physical profiles. As research increases and more drugs become available for pediatric use, the issue of polypharmacy becomes more of a concern. Polypharmacy is defined as the practice of administering or using multiple medications concurrently for the treatment of one to several medical disorders. With the increased rates of diagnosed complex disease states as prescribed mediations in pediatric patients, the prevalence and effect of polypharmacy in this patient population is largely a mystery. Polypharmacy falls within the realm of expertise of specialized pharmacists who can undertake medication therapy management services, medical chart reviews, and other services in pediatrics. Pharmacists have the time and knowledge to undertake pertinent interventions when managing polypharmacy and can play a major positive role in preventing adverse events. The aim of this paper is to review the literature on pediatric polypharmacy and provide insight into opportunities for pharmacists to help with management of polypharmacy. Information on adverse events, efficacy, and long-term outcomes with regard to growth and development of children subject to polypharmacy has yet to be published, leaving this realm of patient safety ripe for research.

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Child, Parent, and Service Predictors of Psychotropic Polypharmacy Among Adolescents and Young Adults with an Autism Spectrum Disorder

Cited by 18 publications

References 55 publications

Characteristics of Arabic Websites with information on autism

Characteristics of Arabic Websites with information on autism

Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders

Polypharmacy in pediatric patients and opportunities for pharmacists' involvement

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Child, Parent, and Service Predictors of Psychotropic Polypharmacy Among Adolescents and Young Adults with an Autism Spectrum Disorder

Cited by 18 publications

References 55 publications

Characteristics of Arabic Websites with information on autism

Characteristics of Arabic Websites with information on autism

Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders

Polypharmacy in pediatric patients and opportunities for pharmacists&#39; involvement

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Product

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Polypharmacy in pediatric patients and opportunities for pharmacists' involvement