Abstract
Objective: The objective of this study was to provide an evaluation of the benefits and adverse effects (AEs) of psychiatric and seizure medications commonly used for individuals with autism spectrum disorder (ASD).Methods: As part of the National Survey on Treatment Effectiveness for Autism, we report ratings of 26 psychiatric and seizure medications by 505 participants. Each medication was rated with a standardized scale for overall benefits, overall AEs, and specific symptoms affected. The frequency of use and net perceived benefit (overall benefit minus overall AE) are reported.Results: Most medications were rated as having a slightly greater benefit than AE. Six medications (lamotrigine, oxcarbazepine, clonidine, guanfacine, buspirone, and sertraline) had benefit ratings that were more than twice their adverse rating. Conversely, some medications had slightly negative net benefit ratings (worse AEs than benefits on average), including Adderall, Paroxetine, Quetiapine, Olanzapine, and Topiramate. However, there were wide variations in individual ratings of benefit and AEs, suggesting that clinical response to medications was highly variable, so these scores simply represent averages. A ranking of the top medications (those with the highest net perceived benefit) for each of 18 different symptoms is provided, which may provide some clinical guidance as to which medications may be most worth considering for a given symptom. A comparison of the survey results with the results of clinical trials shows generally good agreement in terms of medication benefits with some differences; in some cases the differences are because the clinical trials did not assess all of the symptoms assessed by this survey.Conclusions: It is hoped that physicians and their patients will find the survey results useful in selecting the most promising medications for a given symptom, and also for monitoring for likely benefits and AEs, especially for medications for which few or no studies have been carried out in ASD populations.
Highlights
Autism Spectrum Disorder (ASD) is a developmental disorder that primarily involves deficits in communication and social skills and restricted/repetitive behaviors
The objective of this study was to provide an evaluation of the benefits and adverse effects (AEs) of psychiatric and seizure medications commonly used for individuals with autism spectrum disorder (ASD)
A ranking of the top medications for each of 18 different symptoms is provided, which may provide some clinical guidance as to which medications may be most worth considering for a given symptom
Summary
Autism Spectrum Disorder (ASD) is a developmental disorder that primarily involves deficits in communication and social skills and restricted/repetitive behaviors. Due to ASD and associated psychiatric symptoms, psychiatric medications are very commonly prescribed to children and adults with ASD. A study by Houghton et al published in 2017 found that about two-third of their ASD cohort (n = 93,639) had taken at least one psychiatric medication, with over one-third of the cohort having taken two or more psychiatric medications. While psychiatric medication use is very common in ASD populations, the only ASD-related medications that are approved by the Food and Drug Administration (FDA) are risperidone and aripiprazole, which are approved for irritability associated with ASD (LeClerc and Easley 2015). There is no FDA-approved medication for treating the core symptoms of ASD (Frye and Rossignol 2016)
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