▸ CNS stimulants. Methylphenidate has proved to be effective in improving hyperactivity, impulsivity, and inattention in some patients without worsening behavior or increasing symptoms, such as stereotypies or irritability, but such is not the case for all patients, Dr. Myers said.
▸ Anticonvulsants. In an open-label study of valproic acid, 10 of 14 patients had a sustained clinical response with decreases in affective instability, impulsivity, aggression, and core symptoms. All of the patients who had any electroencephalograph abnormalities or seizures responded to valproic acid (J. Clin. Psychiatry 2001;62:530–4). Lamotrigine (Lamictal) did not have any noticeable effects separate from placebo in a double-blind trial of 28 autistic patients, despite some encouraging results in a previous open-label trial (J. Autism Dev. Disord. 2001;31:175–81; Neuropediatrics 1994;25:284–9).