Abstract
Individuals with autism spectrum disorder (ASD) frequently display intensely repetitive, restricted thoughts, and behaviors. These behaviors have similarities to compulsions and/or obsessions in obsessive compulsive disorder (OCD) and are primarily treated with behaviourally-based interventions and serotonin uptake inhibitors (SSRIs). Due to the lack of treatment responses in many cases, however, new treatments are being sought. Here we report beneficial effects of treatment with liraglutide, a glucagon-like peptide-1 (GLP-1) analog, on severe obsessive food craving, binge eating, weight gain, and behavioral problems in an adolescent male with infantile autism and moderate intellectual impairment. Liraglutide treatment reduced weight and unwanted behavior seemingly by preventing food-related repetitive thoughts and compulsions. Our report provides clinical evidence that GLP-1 signaling pathway may represent a novel target for treating food-related behavioral problems and aggressive behavior in ASD.
Highlights
Restricted and repetitive thoughts and behaviors (RRBs) appearing inappropriate to the situation and odd in context represent some of the core diagnostic features in autism spectrum disorder (ASD) and associate with difficulties in interpreting everyday social signals and limited language and cognitive capabilities in ASD individuals [1]
It has been postulated that centrally-mediated vagal efferent activity, regulated via hypothalamus through repetitive and increased food ingestion as well as via increased circulating free fatty acids contribute to the effects of atypical antipsychotics [15]
The rapid weight gain caused by antipsychotics did not associate with alterations of serum lipids in our patient case, albeit marginal increases in alanine amino transferase as well as reduced serum thyroxine concentration during risperidone treatment suggested some metabolic changes
Summary
Restricted and repetitive thoughts and behaviors (RRBs) appearing inappropriate to the situation and odd in context represent some of the core diagnostic features in autism spectrum disorder (ASD) and associate with difficulties in interpreting everyday social signals and limited language and cognitive capabilities in ASD individuals [1]. Rote learning and digit span were within the normal range with all other functions being notably compromised His level of autistic symptoms as assessed across lifespan were significantly elevated (Social Communication Questionnaire life-time version score 24). His level of social functioning was moderately impaired (Social Responsiveness Scale T-score 69, with most pronounced deficits seen in social cognition and autistic mannerisms). No adverse side effects of liraglutide were observed in our patient case
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