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Review
. 2012 Sep;14(3):263-79.
doi: 10.31887/DCNS.2012.14.3/cdoyle.

Pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders across the lifespan

Carolyn A Doyle  1 , Christopher J McDougle
Affiliations
Review

Pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders across the lifespan

Carolyn A Doyle et al. Dialogues Clin Neurosci. 2012 Sep.

Abstract
in English, Spanish, French

This review outlines pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders (ASDs) in children, adolescents, and adults. Symptom domains include repetitive and stereotyped behaviors, irritability and aggression, hyperactivity and inattention, and social impairment. Medications covered include serotonin reuptake inhibitors (SRIs), mirtazapine, antipsychotics, psychostimulants, atomoxetine, α-2 agonists, D-cycloserine, and memantine. Overall, SRIs are less efficacious and more poorly tolerated in children with ASDs than in adults. Antipsychotics are the most efficacious drugs for the treatment of irritability in ASDs, and may be useful in the treatment of other symptoms. Psychostimulants demonstrate some benefit for the treatment of hyperactivity and inattention in individuals with ASDs, but are less efficacious and associated with more adverse effects compared with individuals with ADHD. D-cycloserine and memantine appear helpful in the treatment of social impairment, although further research is needed.

Esta revisión describe los tratamientos farmacológicos para los síntomas conductuales asociados con los trastornos del espectro autista (TEA) en niños, adolescentes y adultos. Los síntomas incluyen conductas estereotipadas repetitivas, irritabilidad y agresividad, hiperactividad e inatención, y deterioro social. Los fármacos incluyen inhibidores de la recaptura de serotonina (IRSs), mírtazapina, anti-psicótícos, psicoestimulantes, atomoxetina, agonistas α-2, D-cicloserina y memantína. Los IRSs como grupo son menos eficaces y peor tolerados en niños que en adultos con TEA. Los antipsicóticos son los fármacos más eficaces para el tratamiento de la irritabilidad en los TEA y pueden ser útiles para el tratamiento de otros síntomas. Los psicoestimulantes muestran algún beneficio para el tratamiento de la hiperactividad y la inatención en sujetos con TEA, pero son menos efectivos y se asocian con más efectos adversos en comparación con sujetos con ADHD. La D-cicloserina y la memantina parecen útiles para el tratamiento del aislamiento social, pero se requiere de más investigación.

Cet article présente les traitements pharmacologiques des symptômes comportementaux associés aux troubles autistiques (TA) chez les enfants, les adolescents et les adultes. Ces symptômes incluent des comportements répétitifs et stéréotypés, une irritabilité et une agressivité, une hyperactivité et un manque d'attention ainsi qu'un handicap social. Les traitements utilisés incluent les inhibiteurs de la recapture de la sérotonine (IRS), la mirtazapine, les antipsychotiques, les psychostimulants, l'atomoxétine, les α-2 agonistes, la D-cyclosérine et la mémantine. Globalement les IRS sont moins efficaces et moins bien tolérés chez les enfants que chez les adultes. Les antipsychotiques sont les produits les plus efficaces pour le traitement de l'irritabilité dans les TA et peuvent être utiles dans le traitement d'autres symptômes. Les psychostimulants font preuve de quelques avantages dans le traitement de l'hyperactivité et de l'inattention chez ceux ayant un TA, mais ils sont moins efficaces et associés à plus d'effets indésirables comparés à ceux ayant un TDAH (trouble déficitaire de l'attention avec hyperactivité). Si la D-cyclosérine et la mémantine sont utiles dans le traitement du dysfonctionnement social, de plus amples recherches sont nécessaires.

Keywords: autism; autism spectrum disorder; autistic disorder; pervasive developmental disorder; treatment.

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