Trazodone Reduced Aggressive and Self-Injurious Movements in a Mentally Handicapped Male Patient with Autism

Gedye, A.

doi:10.1097/00004714-199108000-00022

Cited by 29 publications

(13 citation statements)

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“…[70] Ramelteon was well tolerated and also induced an improvement on the Clinical Global Impression (CGI) -Improvement scale. A few case studies have reported some benefit with trazodone, [71][72][73] while an open-label study examined the efficacy and tolerability of mirtazapine (dosage range 7.5-45 mg day) in the treatment of associated symptoms of ASD. [74] Nine of the 26 participants (34.6%) were judged to be responders ('much improved' or 'very much improved' on the CGI scale).…”

Section: Drug Therapymentioning

confidence: 99%

Epidemiology and Management of Insomnia in Children with Autistic Spectrum Disorders

Miano

Ferri

2010

Pediatric Drugs

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Insomnia is the predominant sleep concern in children with autistic spectrum disorder (ASD), and its nature is most likely multifactorial, with neurochemical (abnormalities in serotonergic transmission or melatonin levels), psychiatric (anxiety), and behavioral (poor sleep habits) etiological factors involved. Children with ASD experience sleep problems similar to those of typically developing children, although the prevalence is markedly higher, occurring in 44-83% of school-aged children with ASD. Caregivers usually report that insomnia is the most frequent sleep disorder, described as disorders of initiating and maintaining sleep, restless sleep, bedtime resistance, co-sleeping, alterations of sleep hygiene, and early awakenings in the morning. Many actigraphic studies have added information on sleep disorders, confirming the questionnaire findings in the majority of cases. There are relatively few polysomnographic data for ASD, compared with questionnaire studies, and most of these studies reported a reduction in total sleep time and more undifferentiated sleep in the youngest patients. These findings were associated with several sleep microstructure alterations during rapid eye movement (REM) sleep, and with non-REM (NREM) sleep microstructure changes that appeared to be related to cognitive impairment rather than to the autistic core. Moreover, few data about other less frequent sleep disorders, such as periodic limb movements disorder and obstructive sleep apnea syndrome, bruxism, and the influence of epilepsy and EEG abnormalities, are available. Both pharmacologic and behavioral interventions have been suggested for the treatment of sleep problems in autistic children. The most common types of behavioral interventions are complete extinction (removing reinforcement to reduce a behavior) and various forms of graduated extinction. Melatonin has shown promising results in the treatment of insomnia in children with ASD. Although controlled studies are limited, there are more data demonstrating the safety and effectiveness of melatonin in ASD than for other sedative/hypnotic drugs. Finally, a dual treatment for insomnia in ASDs with melatonin and behavioral techniques has been suggested. A recent study using a combination of genetic and functional experimental techniques reported evidence that low melatonin concentration caused by a primary deficit in acetylserotonin methyltransferase activity is a risk factor for ASD. Sleep problems usually start at the same age as developmental regression, suggesting a higher vulnerability at this period of life. Further studies, beginning at younger ages, are necessary to better investigate these aspects and the role of melatonin in insomnia in children with ASD.

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Section: Drug Therapymentioning

confidence: 99%

Epidemiology and Management of Insomnia in Children with Autistic Spectrum Disorders

Miano

Ferri

2010

Pediatric Drugs

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“…Even though aggression during the no-treatment phase was lower than baseline, the second treatment phase still showed a 90% drop in aggression compared to the notreatment phase. It is possible that central serotonin temporarily accumulates in persons previously depleted because second baseline rates were lower in this study and another (Gedye, 1991c), reflecting temporary amehoration. If the patient were off treatment for several weeks of a second baseline-an ethically questionable practice once treatment has shown dramatic benefit-then the frequency of involuntary movements would eventually return to first baseline levels (unpublished data inadvertently acquired).…”

Section: Resultsmentioning

confidence: 58%

Serotonergic treatment for aggression in a Down's syndrome adult showing signs of Alzheimer's disease

Gedye¹

1991

J intellect Disabil Res

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Sudden-onset, unprovoked aggression has typically been difficult to reduce or eliminate in persons with mental handicaps or dementia. Several medications have been reported in the literature with varying success, though some risk serious side effects. This study tested the effectiveness of a low dose antidepressant (trazodone) with a serotonin-enhancing diet to reduce aggression while not risking serious side effects. Aggression decreased by 96% in a mentally handicapped adult with Down's syndrome showing signs of Alzheimer-type dementia. The benefit was robustly demonstrated using an on-off-on-again design wtih detailed recording for nearly 4 months.

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“…Trazodone was associated with reduction of aggression and self-injuries behavior in a single case report of 17-yearold male with autism and mental retardation [73]. However, another case study [74] showed that long-term use of trazodone (100 mg) in a 13-year-old boy with autism was associated with the adverse effect of priapism.…”

Section: Trazodonementioning

confidence: 94%

Recent Advances in the Pharmacological Treatment of Pervasive Developmental Disorders

Moussavand

Findling

2007

CPR

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Introduction. There is growing body of evidence to suggest that pharmacotherapy may be a rational form of intervention for some patients with pervasive developmental disorders (PDDs). The purpose of this article is to describe what is known about medication treatment for these patients. Methods.Published papers regarding the pharmacotherapy of PDDs were collected and reviewed. For each study, particular attention was paid to ascertaining patient characteristics, the medication doses employed, and medication tolerability.Results. There is evidence of varying methodological rigor to suggest that several medications may have a role in the treatment of patients with PDDs. However, to date, few randomized double-blind treatment studies have been published. In addition, there is very little known about the long-term safety of many of these agents in this patient population.Conclusions. Some patients with PDDs may benefit acutely from pharmacotherapy. Many marketed psychotropic agents that putatively hold promise for these patients have not been rigorously studied. More short-term and long-term research regarding the pharmacotherapy of patients with PDDs is needed.

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Trazodone Reduced Aggressive and Self-Injurious Movements in a Mentally Handicapped Male Patient with Autism

Cited by 29 publications

References 0 publications

Epidemiology and Management of Insomnia in Children with Autistic Spectrum Disorders

Epidemiology and Management of Insomnia in Children with Autistic Spectrum Disorders

Serotonergic treatment for aggression in a Down's syndrome adult showing signs of Alzheimer's disease

Recent Advances in the Pharmacological Treatment of Pervasive Developmental Disorders

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