Document Detail


A systematic review of medical treatments for children with autism spectrum disorders.
MedLine Citation:
PMID:  21464191     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: As many as 1 in every 110 children in the United States has an autism spectrum disorder (ASD). Many medical treatments for ASDs have been proposed and studied, but there is currently no consensus regarding which interventions are most effective.
OBJECTIVE: To systematically review evidence regarding medical treatments for children aged 12 years and younger with ASDs.
METHODS: We searched the Medline, PsycInfo, and ERIC (Education Resources Information Center) databases from 2000 to May 2010, regulatory data for approved medications, and reference lists of included articles. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Studies of secretin were not included in this review. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of-evidence ratings on the basis of predetermined criteria.
RESULTS: Evidence supports the benefit of risperidone and aripiprazole for challenging and repetitive behaviors in children with ASDs. Evidence also supports significant adverse effects of these medications. Insufficient strength of evidence is present to evaluate the benefits or adverse effects for any other medical treatments for ASDs, including serotonin-reuptake inhibitors and stimulant medications.
CONCLUSIONS: Although many children with ASDs are currently treated with medical interventions, strikingly little evidence exists to support benefit for most treatments. Risperidone and aripiprazole have shown benefit for challenging and repetitive behaviors, but associated adverse effects limit their use to patients with severe impairment or risk of injury.
Authors:
Melissa L McPheeters; Zachary Warren; Nila Sathe; Jennifer L Bruzek; Shanthi Krishnaswami; Rebecca N Jerome; Jeremy Veenstra-Vanderweele
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2011-04-04
Journal Detail:
Title:  Pediatrics     Volume:  127     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  2011-07-11     Revised Date:  2011-11-21    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1312-21     Citation Subset:  AIM; IM    
Affiliation:
465 21st Ave S, 7158 Medical Research Building III, Nashville, TN 37232, USA.
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MeSH Terms
Descriptor/Qualifier:
Antipsychotic Agents / administration & dosage*,  adverse effects
Child
Child Development Disorders, Pervasive / diagnosis*,  drug therapy*
Child, Preschool
Citalopram / administration & dosage,  adverse effects
Dose-Response Relationship, Drug
Drug Administration Schedule
Evidence-Based Medicine
Female
Fluoxetine / administration & dosage,  adverse effects
Humans
Male
Patient Compliance
Piperazines / administration & dosage*,  adverse effects
Prognosis
Quinolones / administration & dosage*,  adverse effects
Randomized Controlled Trials as Topic
Risperidone / administration & dosage*,  adverse effects
Serotonin Antagonists / administration & dosage,  adverse effects
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antipsychotic Agents; 0/Piperazines; 0/Quinolones; 0/Serotonin Antagonists; 106266-06-2/Risperidone; 129722-12-9/aripiprazole; 54910-89-3/Fluoxetine; 59729-33-8/Citalopram
Comments/Corrections
Comment In:
J Pediatr. 2011 Nov;159(5):872-3   [PMID:  21996118 ]
Evid Based Ment Health. 2011 Nov;14(4):105   [PMID:  21963708 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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