ASD

Question 1

Antipsychotics

Answer 1

ASD
• Antipsychotics are the most studied medication treatment in ASD, but studies are still lacking and may be limited by external validity
• Antipsychotics used to treat primarily *irritability and *aggression
• May help with stereotypical behaviors, hyperactivity, and self-injury
• *Atypical Antipsychotics primarily used

Question 2

Risperidone (Risperdal), aripiprazole (Abilify)

Answer 2

ASD
Atypical Antipsychotics
- the only FDA-approved medications for the treatment of *irritability
MOA
• D2 and 5-HT 2A receptor antagonists
ADE
o Drowsiness and/or activation, increased appetite/weight gain, orthostatic hypotension (esp as pt getting used to meds)
o Monitor weight, blood glucose, lipids, and EKG at baseline and periodically

Question 3

Chlorpromazine, haloperidol

Answer 3

ASD
Typical Antipsychotics
- FDA-approved for severe behavioral problems in children (but *not specifically for ASD)
o Use is limited by significant adverse effects (don’t see these as often)

Question 4

Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer 4

ASD
Antidepressants
- shown some improvement with related symptoms, such as aggression, mood, and repetitive behaviors
o None are approved for this indication
o May be *stimulating, especially during initiation (pt getting used to meds)

Question 5

Tricyclic Antidepressants (TCAs)

Answer 5

ASD
Antidepressants
- may be used but have much *more adverse effects than SSRI
• Concern with *suicidal ideation

Question 6

Anxiolytics

Answer 6

ASD
Other Pharm tx
- for anxiety symptoms

Question 7

antiepileptic, lithium

Answer 7

ASD
Other Pharm tx
- for coexisting mood disorders
o Not approved for ASD and need to monitor cautiously

Question 8

Stimulants, alpha2 agonists

Answer 8

ASD
Other Pharm tx
- used for hyperactivity and inattention
o Most data in patients with *comorbid ADHD
o Most data with *methylphenidate
o Limited data with *atomoxetine (Strattera)

Question 9

Melatonin, Secretin, Omega-3 Fatty Acids, Gluten-free diets and vitamin supplements

Answer 9

ASD
Complementary and Alternative Medicine
• Commonly used, but minimal (if any) data
o Not FDA-approved or regulated (FDA has to prove unsafe to remove)
• Possibility of drug interactions or additive adverse effects
MOA
o *Melatonin for sleep
o *Secretin for GI (a hypothetical association)
o *Omega-3 Fatty Acids (theorized to be low in ASD)
o *Gluten-free diets and *vitamin supplements