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Psychopharmacology

Introduction

Psychotropic medications can be an important part of the treatment of children and adolescents with autism-spectrum disorders. This lecture reviews target symptoms that can be successfully treated with medications, including:

  1. Aggressive, irritable and self-injurious behaviors, for which the atypical antipsychotic risperidone has the best evidence-based track record (including FDA labeling specific for this indication);
  2. Inattention and hyperactivity, for which stimulant medications can be moderately useful, although not as effective, and with more side effects that are seen in typically-developing youths; and
  3. Repetitive behaviors, for which serotonergic antidepressants have not proved to be helpful, despite considerable early interest and promising results.

In addition, the lecture will cover medication intervention that have been tried but not proven effective, including the gastrointestinal hormone secretin, which remains the most extensively studied compound to date. Other topics covered include the prevalence of medication use in autism, the costs of these interventions, and promising leads for future drug development in autism.

Featured Reading

The featured reading for the Psychopharmacology class lecture comes from:

Research Units on Pediatric Psychopharmacology Autism Network 2005a, ‘Risperidone treatment of autistic disorder: longer-term benefits and blinded discontinuation after six months’, Am J Psychiatry, vol. 162, pp. 1361-1369.

This study showed the lasting effects of risperidone six months after the results from the acute double-blind trial. Of note, relapse rates were so high in the group assigned to placebo discontinuation, that the stud had to be prematurely terminated and subjects allowed to go back on active medication.

Read the full article at The New England Journal of Medicine's website.