Rating of the effectiveness of 26 psychiatric and seizure medications for autism spectrum disorder: Results of a national survey
Open accessAbstract
Objective: The objective of this study was to provide an evaluation of the benefits and adverse effects (AEs) of psychiatric and seizure medications commonly used for individuals with autism spectrum disorder (ASD). Methods: As part of the National Survey on Treatment Effectiveness for Autism, we report ratings of 26 psychiatric and seizure medications by 505 participants. Each medication was rated with a standardized scale for overall benefits, overall AEs, and specific symptoms affected. The frequency of use and net perceived benefit (overall benefit minus overall AE) are reported. Results: Most medications were rated as having a slightly greater benefit than AE. Six medications (lamotrigine, oxcarbazepine, clonidine, guanfacine, buspirone, and sertraline) had benefit ratings that were more than twice their adverse rating. Conversely, some medications had slightly negative net benefit ratings (worse AEs than benefits on average), including Adderall, Paroxetine, Quetiapine, Olanzapine, and Topiramate. However, there were wide variations in individual ratings of benefit and AEs, suggesting that clinical response to medications was highly variable, so these scores simply represent averages. A ranking of the top medications (those with the highest net perceived benefit) for each of 18 different symptoms is provided, which may provide some clinical guidance as to which medications may be most worth considering for a given symptom. A comparison of the survey results with the results of clinical trials shows generally good agreement in terms of medication benefits with some differences; in some cases the differences are because the clinical trials did not assess all of the symptoms assessed by this survey. Conclusions: It is hoped that physicians and their patients will find the survey results useful in selecting the most promising medications for a given symptom, and also for monitoring for likely benefits and AEs, especially for medications for which few or no studies have been carried out in ASD populations.
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Evidence from case reports and clinical trials indicates guanfacine can be helpful in boosting top-down control to reduce oppositional, self-injurious and repetitive behaviors in children on the autism spectrum, including children with severe cognitive impairment.
“Evidence from case reports and clinical trials indicate that guanfacine can be helpful in boosting top down control to reduce oppositional, self-injurious and repetitive behaviors in children on the autism spectrum, including children with severe (e.g. nonverbal) cognitive impairment”
From Guanfacine’s mechanism of action in treating prefrontal cortical disorders: Successful translation across species (2020) · cites this paper as Coleman et al., 2019
The Results sections on psychiatric medications and top medications for different symptoms (page not specified) report survey-rated improvements with guanfacine in attention, cognition, hyperactivity, and aggression/agitation, and mention trial evidence for hyperactivity and inattention. They do not establish a top-down-control mechanism or benefit for oppositional, self-injurious, or repetitive behaviors specifically, including in children with severe cognitive impairment; the paper says self-injury and stimming/perseveration were not significantly affected by the medications surveyed overall. (LLM, conf=0.88)
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- Authors
- Coleman, D. M., Adams, J. B., Anderson, A. L., & Frye, R. E.
- Affiliations
- Arizona State University (US)
- Barrow Neurological Institute (US)
- Corresponding author
- Adams, James B.
- Venue
- Journal of Child and Adolescent Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2019-03
- Volume
- 29
- Issue
- 2
- Pages
- 107-123
- ISSN
- 1044-5463 (ISSN-L)
- 1557-8992
- PMC
- PMC6442266
- OpenAlex
- W2912990928
- Cited by
- 56
- References
- 31
- Citations by year
- 2025: 7 · 2024: 5 · 2023: 11 · 2022: 11 · 2021: 12 · 2020: 7 · 2019: 3
- FWCI
- 4.80
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Child and Adolescent Psychopharmacology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Autism Speaks
- Organization for Autism Research
- Northwestern University
- Autism Research Institute
- Zynerba Pharmaceuticals
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- autism spectrum disorder, psychiatric medication, antiepileptic drugs, seizure medications, perceived treatment effectiveness, adverse effects, lamotrigine, oxcarbazepine, clonidine, guanfacine, buspirone, sertraline, topiramate, olanzapine, quetiapine, paroxetine, Adderall
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Adult, Anticonvulsants, Child, Female, Humans, Male, Psychotropic Drugs, Surveys and Questionnaires, Treatment Outcome, Young Adult
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