Selected Potential Medication Options for Common Target Symptoms or Coexisting Diagnoses in Children With ASDs
Target Symptom Cluster | Potential Coexisting Diagnoses | Selected Medication Considerations | Selected References |
---|---|---|---|
Repetitive behavior, behavioral rigidity, obsessive-compulsive symptoms | Obsessive-compulsive disorder, stereotypic movement disorder | SSRIs (fluoxetine,a fluvoxamine,a citalopram, escitalopram, paroxetine, sertraline) | McDougle et al,158,b Buchsbaum et al,180,b Sugie et al,159,b Hollander et al,157,b Moore et al,160,c Namerow et al,181,d Owley et al182,d |
Atypical antipsychotic agents (risperidone,a aripiprazole, olanzapine, quetiapine, ziprasidone) | McDougle et al164,b | ||
Valproic acida | Hollander et al183,b | ||
Hyperactivity, impulsivity, inattention | Attention-deficit/hyperactivity disorder | Stimulants (methylphenidate,a dextroamphetamine, mixed amphetamine salts) | Quintana et al,168,b Handen et al,169,b RUPP Autism Network170,b |
α2-agonists (clonidine,a guanfacine) | Fankhauser et al,172,b Jaselskis et al,173,b Posey et al,175,d Scahill et al (RUPP Autism Network)174,d | ||
Atomoxetinea | Arnold et al,178,b Jou et al,176,d Posey et al177,d | ||
Atypical antipsychotic agents (risperidone,a aripiprazole, olanzapine,a quetiapine, ziprasidone) | McCracken et al,162,b Arnold et al,163,b Shea et al,165,b RUPP Autism Network,166,b Troost et al167,d | ||
Aggression, explosive outbursts, self-injury | Intermittent explosive disorder | Atypical antipsychotic agents (risperidone,a aripiprazole, olanzapine, quetiapine, ziprasidone) | McCracken et al,162,b Arnold et al,163,b Shea et al,165,b RUPP Autism Network,166,b Troost et al167,d |
α2-agonists (clonidine,a guanfacine) | Fankhauser et al,172,b Jaselskis et al,173,b Posey et al175,d | ||
Anticonvulsant mood stabilizers (levetiracetam, topiramate, valproic acid) | Hollander et al184,d, Rugino and Samsock185,d, Hardan et al186,d, Myers148,c, Myers and Challman149,c | ||
SSRIs (fluoxetine,a fluvoxamine,a citalopram, escitalopram, paroxetine, sertraline) | McDougle et al,158,b Moore et al,160,c Namerow et al,181,d Owley et al182,d | ||
β-blockers (propranolol, nadolol, metoprolol, pindolol) | Connor et al,187,d Ratey et al,188,d Myers and Challman149,c | ||
Sleep dysfunction | Circadian rhythm sleep disorder, dyssomnia–not otherwise specified | Melatonin | Giannotti et al,136,d Jan and Freeman,131,c Phillips and Appleton,133,c Turk,134,c Owens et al128,c |
Ramelteon | Stigler et al137,e | ||
Antihistamines (diphenhydramine, hydroxyzine) | Reed and Findling,189,c Owens et al128,c | ||
α2-agonists (clonidine, guanfacine) | Mehta et al,190,d Ingrassia and Turk,191,d Posey et al,175,d Owens et al128,c | ||
Mirtazapine | Posey et al192,d | ||
Anxiety | Generalized anxiety disorder, anxiety disorder–not otherwise specified | SSRIs (fluoxetine,a fluvoxamine,a citalopram, escitalopram, paroxetine, sertraline) | McDougle et al,158,b Buchsbaum et al,180,b Sugie et al,159,b Hollander et al,157,b Moore et al,160,c Namerow et al,181,d Owley et al182,d |
Buspirone | Buitelaar et al193,d | ||
Mirtazapine | Posey et al192,d | ||
Depressive phenotype (marked change from baseline including symptoms such as social withdrawal, irritability, sadness or crying spells, decreased energy, anorexia, weight loss, sleep dysfunction) | Major depressive disorder, depressive disorder–not otherwise specified | SSRIs (fluoxetine,a fluvoxamine,a citalopram, escitalopram, paroxetine, sertraline) | McDougle et al,158,b Moore et al,160,c Namerow et al,181,d Owley et al182,d |
Mirtazapine | Posey et al192,d | ||
Bipolar phenotype (behavioral cycling with rages and euphoria, decreased need for sleep, manic-like hyperactivity, irritability, aggression, self-injury, sexual behaviors) | Bipolar I disorder, bipolar disorder–not otherwise specified | Anticonvulsant mood stabilizers (carbamazepine, gabapentin, lamotrigine, oxcarbazepine, topiramate, valproic acid) | Kowatch and DelBello,194,c Myers and Challman149,c |
Atypical antipsychotic agents (risperidone, aripiprazole, olanzapine, quetiapine, ziprasidone) | Cheng-Shannon et al,195,c Kowatch and DelBello,194,c Myers,148,c Myers and Challman149,c | ||
Lithium | DeLong,196,e Kerbeshian et al,197,e Steingard and Biederman,198,e Myers,148,c Myers and Challman149,c |