Drug therapy algorithms target autism’s problem behaviors
Having an evidence-based game plan can help you manage maladaptive behaviors that are holding back children or adults with autism.
Quintana et al conducted a double-blind, crossover study of methylphenidate, 10 or 20 mg bid for 2 weeks, in 10 children ages 7 to 11 with autism.27 Although irritability and hyperactivity showed statistically significant improvement as determined by the ABC and Conners Teacher Questionnaire, the authors reported only modest clinical effects. More recently, use of methylphenidate, 0.3 and 0.6 mg/kg/dose, was associated with a 50% decrease on the Connors Hyperactivity Index in 8 of 13 autistic children ages 5 to 11.28 Adverse effects—most common with the 0.6 mg/kg/dose—included social withdrawal and irritability in this double-blind, placebo-controlled, crossover study.
Related resources
- McDougle CJ, Posey DJ. Autistic and other pervasive developmental disorders. In: Martin A, Scahill L, Charney DS, Leckman JF (eds). Pediatric psychopharmacology: Principles and practice. New York: Oxford University Press, 2002.
- Davis KL, Charney D, Coyle JT, Nemeroff C (eds). Neuropsychopharmacology: the fifth generation of progress. Philadelphia: Lippincott Williams & Wilkins, 2002.
- National Institute of Mental Health. Autism booklet. www.nimh.nih.gov/publicat/autism.cfm
- Autism Society of America. www.autism-society.org
Drug brand names
- Clomipramine • Anafranil
- Clonidine • Catapres
- Clozapine • Clozaril
- Divalproex sodium • Depakote
- Fluoxetine • Prozac
- Fluvoxamine • Luvox
- Guanfacine • Tenex
- Lamotrigine • Lamictal
- Lithium • Eskalith
- Methylphenidate • Ritalin
- Mirtazapine • Remeron
- Olanzapine • Zyprexa
- Paroxetine • Paxil
- Quetiapine • Seroquel
- Risperidone • Risperdal
- Sertraline • Zoloft
- Ziprasidone • Geodon
Disclosure
Dr. Stigler reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
Dr. Posey receives grant support from and is a consultant to Eli Lilly & Co.
Dr. McDougle receives grant support from and is a consultant to Pfizer Inc., Eli Lilly & Co., and Janssen Pharmaceutica, and is a speaker for Pfizer Inc. and Janssen Pharmaceutica.
Acknowledgments
This work was supported in part by a Daniel X. Freedman Psychiatric Research Fellowship Award (Dr. Posey), a National Alliance for Research in Schizophrenia and Depression Young Investigator Award (Dr. Posey), a Research Unit on Pediatric Psychopharmacology contract (N01MH70001) from the National Institute of Mental Health to Indiana University (Drs. McDougle and Posey), a National Institutes of Health Clinical Research Center grant to Indiana University (M01-RR00750), and a Department of Housing and Urban Development grant (B-01-SP-IN-0200).
