Evidence-Based Reviews

Drug therapy algorithms target autism’s problem behaviors

Current Psychiatry. 2003 April;2(4):33-48

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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).