Which drug will help autistic people the most

Cochrane

background

Aripiprazole is an antipsychotic - a type of drug used to treat serious mental disorders, such as paranoia. It is also used to treat behavioral problems (e.g. aggression, severe tantrums) in people with Autism Spectrum Disorders (ASD). It has been shown that aripiprazole is well tolerated and improves behavioral disorders in other conditions such as schizophrenia and bipolar disorder. Because aripiprazole is a relatively new drug, it is important to understand both the benefits and side effects of this drug in patients with ASA.

Question

Do children and adults with ASA benefit from treatment with aripiprazole compared to other children and adults with ASA who receive a drug without an active ingredient (placebo)?

Study characteristics

In this review we included three studies that examined the effects of aripiprazole. Two of them were short-term (8 week) studies examining whether aripiprazole improved behavioral disorders in a total of 316 children and adolescents. The third was a longer-term (up to 16 weeks) study in which 85 children and adolescents whose symptoms initially improved with aripiprazole stopped taking the drug to assess whether their behavior problems would recur. All participants were between six and 17 years old. All studies used several behavioral checklists to measure symptoms of ASD.

Main results and quality of the evidence

Short-term studies found improvements in irritability, hyperactivity, stereotypy (i.e. repetitive behaviors), and inappropriate speech in children and adolescents with ASA who took aripiprazole compared to placebo. Researchers found no improvement in lethargy / withdrawal (i.e. lack of energy and decreased alertness). White children and adolescents were less likely to have relapse (return to older, problematic behaviors) with aripriprazole. However, this result has not been reported in children and adolescents of other races. The rates of side effects as movement disorders such as tremors, muscle stiffness, and involuntary movements were higher in children and adolescents with aripiprazole in all studies. The results of this review suggest that short-term treatment with Ariprazole may improve irritability, hyperactivity, and repetitive movements in children and adolescents with ASD, although weight gain and neurological side effects (for example, involuntary movements of the face and jaw) may occur. Children and adolescents taking aripripazole should be checked regularly to see improvements in ASA symptoms and side effects. Overall, the quality of the evidence was moderate. An updated version of the Manual for Diagnosing ASD and Other Diseases has been published since these studies were conducted. Further studies evaluating the safety and benefits of long-term use of aripiprazole would be helpful.