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The Role of Antipsychotics in the Management of Behavioural Symptoms in Children and Adolescents with Autism

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Abstract

Autistic disorder or autism is a serious childhood-onset disorder that affects all areas of development, particularly in the areas of language, communication and reciprocal social interaction. Patients with autistic disorder typically demonstrate repetitiveness and a restricted repertoire of behaviour. Additionally, they also have a number of disruptive symptoms that may be reduced by drug treatment, including severe tantrums, hyperactivity and lability.

Antipsychotic drugs are the agents that are the most critically studied as treatments for reducing symptoms. Both first- and second-generation antipsychotics have shown safety and efficacy in short- and long-term studies in autism. The most studied antipsychotic drugs include haloperidol and risperidone, although studies of other antipsychotic drugs are underway. Safety concerns associated with treatment include the risk of drug-related dyskinesias, which is greater with the first-generation drugs, and the risk of weight gain and associated metabolic problems (i.e. increases in glucose and lipids), which is greater with second-generation agents. Prescription of antipsychotic drugs requires careful monitoring because of these safety risks and the likelihood of long-term use. Drug administration should be initiated at low dosages and subsequent dosage changes should be based on tolerability and clinical response.

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Acknowledgements

No funding was provided for the preparation of this review. Dr Malone has received funds to conduct studies from Bristol Meyers Squibb, Johnson & Johnson, Pfizer and Lilly, and was a consultant to Lilly on PDDs. He has also received funding from the US FDA Orphan Product division and the National Institute of Mental Health to conduct research in autism. Dr Waheed has no potential conflicts to declare.

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  1. Drexel Autism Center, Drexel University College of Medicine, c/o Friends Hospital, 4641 Roosevelt Boulevard, Philadelphia, Pennsylvania, 19124, USA

    Richard P. Malone & Ayesha Waheed

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  1. Richard P. Malone
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  2. Ayesha Waheed
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Correspondence to Richard P. Malone.

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Malone, R.P., Waheed, A. The Role of Antipsychotics in the Management of Behavioural Symptoms in Children and Adolescents with Autism. Drugs 69, 535–548 (2009). https://doi.org/10.2165/00003495-200969050-00003

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