Reboxetine Treatment for Autistic Spectrum Disorder of Pediatric Patients With Depressive and Inattentive/Hyperactive Symptoms

Golubchik, Pavel; Sever, Jonathan; Weizman, Abraham

doi:10.1097/wnf.0b013e31828003c1

Cited by 23 publications

(3 citation statements)

References 35 publications

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“…Results indicated that youth with ADHD and ASD moderately improved their ADHD symptoms and adverse effects were comparable between atomoxetine and placebo conditions. Another selective norepinephine reuptake inhibitor, reboxetine, has also been tested empirically as a non-stimulant treatment in the ASD population [162]. In a 12-week open-label trial using a sample of 11 adolescents with ASD (mean age = 12) and depressive/ADHD symptoms, reboxetine (maximal dose, 4 mg/day) resulted in statistically significant, albeit modest, decreases in the severity of ADHD symptoms (p = 0.015).…”

Section: Non-stimulant Medicationsmentioning

confidence: 99%

The comorbidity of ADHD and autism spectrum disorder

Antshel

Zhang-James

Faraone

2013

Expert Review of Neurotherapeutics

126

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ADHD and autism spectrum disorder are common psychiatric comorbidities to each another. In addition, there is behavioral, biological and neuropsychological overlap between the two disorders. There are also several important differences between autism spectrum disorder and ADHD. Treatment strategies for the comorbid condition will also be reviewed. Future areas of research and clinical need will be discussed.

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Section: Non-stimulant Medicationsmentioning

confidence: 99%

The comorbidity of ADHD and autism spectrum disorder

Antshel

Zhang-James

Faraone

2013

Expert Review of Neurotherapeutics

126

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“…The most common classes were stimulants, alpha-agonists or atomoxetine (30.2%), antipsychotics (20.5%), and antidepressants (17.8%). 47,48 A systematic review of seven studies (of which, two are large-sample studies of citalopram and fluoxetine) that examined the effectiveness of SSRIs in ASD patients did not find any therapeutic benefits for this class of medication for social communicational symptoms of ASD, but found evidence for benefits in treatment of repetitive behaviors associated with ASD. 49 Interestingly, sulforaphane, an isothiocyanate naturally abundant in broccoli, which upregulates genes that protect aerobic cells against oxidative stress, inflammation, and DNA-damage (all of which are prominent and possibly mechanistic characteristics of ASD) demonstrated in a double-blind randomized trial, significant improvement in the behavioral symptoms of ASD.…”

Section: Discussionmentioning

confidence: 99%

Use of selective serotonin and norepinephrine reuptake inhibitors (SNRIs) in the treatment of autism spectrum disorder (ASD), comorbid psychiatric disorders and ASD-associated symptoms: a clinical review

et al. 2020

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It is challenging to treat symptoms of autism spectrum disorder (ASD), comorbid psychiatric disorders and ASD-associated symptoms. Some of the commonly used medications to treat these can, and frequently do have serious adverse side effects. Therefore, it is important to identify medications that are effective and with fewer side effects and negative outcomes. In this review, we looked at current evidence available for using the serotonin and norepinephrine reuptake inhibitors (SNRIs) class of medications in treating some of these often difficult to treat symptoms and behaviors. An extensive literature search was conducted using EBSCO.host. Our search algorithm identified 130 articles, 6 of which were deemed to meet criteria for the purpose of this review. Each of these six articles was independently reviewed and critically appraised. As a prototype of the SNRIs family, venlafaxine was found to be a useful adjuvant in children and adults with ASD for the treatment of self-injurious behaviors, aggression, and ADHD symptoms when used in doses lower than its antidepressant dosage. However, duloxetine was not found to show any added benefit in treatment of any of the comorbid symptoms and behaviors in ASD when compared to other antidepressants. On the other hand, milnacipran was reported to produce improvements in impulsivity, hyperactivity symptoms, and social functioning through reduction of inattention of ADHD when comorbid with ASD. Overall, SNRIs were shown variable effectiveness in treatment of these comorbid symptoms and behaviors in ASD.

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“…Clonidine improved irritability and hyperactivity [211], reduced hyperarousal, improved social behavior [212], reduced impulsivity, improved attention, lessened hyperreactivity, and improved sleep [213] in ASDs. A recent open-label trial of reboxetine, a selective NE reuptake inhibitor, improved depression and ADHD symptoms in adolescents with ASDs [214]. Larger tonic pupil-size in ASD inversely correlates with a marker for peripheral NE [215].…”

Section: Cognitive Dysfunction Due To Pathology In the A2 Neurons mentioning

confidence: 99%

Proposed Toxic and Hypoxic Impairment of a Brainstem Locus in Autism

McGinnis

Audhya

Edelson

2013

IJERPH

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Electrophysiological findings implicate site-specific impairment of the nucleus tractus solitarius (NTS) in autism. This invites hypothetical consideration of a large role for this small brainstem structure as the basis for seemingly disjointed behavioral and somatic features of autism. The NTS is the brain’s point of entry for visceral afference, its relay for vagal reflexes, and its integration center for autonomic control of circulatory, immunological, gastrointestinal, and laryngeal function. The NTS facilitates normal cerebrovascular perfusion, and is the seminal point for an ascending noradrenergic system that modulates many complex behaviors. Microvascular configuration predisposes the NTS to focal hypoxia. A subregion—the “pNTS”—permits exposure to all blood-borne neurotoxins, including those that do not readily transit the blood-brain barrier. Impairment of acetylcholinesterase (mercury and cadmium cations, nitrates/nitrites, organophosphates, monosodium glutamate), competition for hemoglobin (carbon monoxide, nitrates/nitrites), and higher blood viscosity (net systemic oxidative stress) are suggested to potentiate microcirculatory insufficiency of the NTS, and thus autism.

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Reboxetine Treatment for Autistic Spectrum Disorder of Pediatric Patients With Depressive and Inattentive/Hyperactive Symptoms

Abstract: Reboxetine treatment may reduce, modestly but significantly, depressive and ADHD symptoms in adolescents with ASD. High rate of adverse effects requires close monitoring.

Cited by 23 publications

References 35 publications

The comorbidity of ADHD and autism spectrum disorder

The comorbidity of ADHD and autism spectrum disorder

Use of selective serotonin and norepinephrine reuptake inhibitors (SNRIs) in the treatment of autism spectrum disorder (ASD), comorbid psychiatric disorders and ASD-associated symptoms: a clinical review

Proposed Toxic and Hypoxic Impairment of a Brainstem Locus in Autism

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