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Cited by 342Autism Spectrum Disorder ResearchAttention Deficit Hyperactivity DisorderChild Nutrition and Feeding Issues

Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology

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Howes, Oliver D, Rogdaki, Maria, Findon, James L, Wichers, Robert H, Charman, Tony, King, Bryan H, Loth, Eva, McAlonan, Gráinne M +7 more·2018·Journal of Psychopharmacology
DOI 10.1177/0269881117741766PMC PMC5805024
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Abstract

An expert review of the aetiology, assessment, and treatment of autism spectrum disorder, and recommendations for diagnosis, management and service provision was coordinated by the British Association for Psychopharmacology, and evidence graded. The aetiology of autism spectrum disorder involves genetic and environmental contributions, and implicates a number of brain systems, in particular the gamma-aminobutyric acid, serotonergic and glutamatergic systems. The presentation of autism spectrum disorder varies widely and co-occurring health problems (in particular epilepsy, sleep disorders, anxiety, depression, attention deficit/hyperactivity disorder and irritability) are common. We did not recommend the routine use of any pharmacological treatment for the core symptoms of autism spectrum disorder. In children, melatonin may be useful to treat sleep problems, dopamine blockers for irritability, and methylphenidate, atomoxetine and guanfacine for attention deficit/hyperactivity disorder. The evidence for use of medication in adults is limited and recommendations are largely based on extrapolations from studies in children and patients without autism spectrum disorder. We discuss the conditions for considering and evaluating a trial of medication treatment, when non-pharmacological interventions should be considered, and make recommendations on service delivery. Finally, we identify key gaps and limitations in the current evidence base and make recommendations for future research and the design of clinical trials.

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  • Similar treatment guidelines published to date are either now outdated or offer guidance on one co-occurring condition but may not serve as a reference across multiple symptom domains, present which drugs may be used in ASD without walking through the nuanced decision-making process of choosing and prescribing a drug to match the unique needs of individual patients, or do not specifically discuss,

    “Similar treatment guidelines published to date are either now outdated or offer guidance on one co-occurring condition but may not serve as a reference across multiple symptom domains, present which drugs may be used in ASD without walking through the nuanced decision-making process of choosing and prescribing a drug to match the unique needs of individual patients, or do not specifically discuss”

    From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [33]

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Authors
Howes, O. D., Rogdaki, M., Findon, J. L., Wichers, R. H., Charman, T., King, B. H., Loth, E., McAlonan, G. M., McCracken, J. T., Parr, J. R., Povey, C., Santosh, P., Wallace, S., Simonoff, E., & Murphy, D. G.
Affiliations
  • King's College London (GB)
  • MRC London Institute of Medical Sciences (GB)
  • University of California, San Francisco (US)
  • The Sackler Centre and Forensic and Neurodevelopmental Science Behavioural and Developmental Psychiatry, Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
  • University of California, Los Angeles (US)
  • Newcastle University (GB)
  • The National Autistic Society (GB)
  • AT-Autism, London, UK
  • South London and Maudsley NHS Foundation Trust (GB)
Corresponding author
Howes, Oliver D
ORCID
Venue
Journal of Psychopharmacology
Publisher
SAGE Publications
Published
2017-12-14
Volume
32
Issue
1
Pages
3-29
ISSN
  • 0269-8811 (ISSN-L)
  • 1461-7285
DOI
10.1177/0269881117741766
PMC
PMC5805024
OpenAlex
W2775647200
Cited by
342
References
290
Citations by year
2026: 18 · 2025: 42 · 2024: 41 · 2023: 44 · 2022: 75 · 2021: 43 · 2020: 47 · 2019: 26 · 2018: 6
FWCI
2.42
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Psychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
  • Eli Lilly and Company
  • National Institute for Health and Care Research (RP-PG-0606-1045, NF-SI-0514-10073)
  • Medical Research Council (MR/N026063/1)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
autism spectrum disorder, etiology, autism assessment, pharmacotherapy, melatonin, sleep disorders, irritability, methylphenidate, atomoxetine, guanfacine, attention deficit hyperactivity disorder, epilepsy, non-pharmacological treatment, service delivery, clinical trial design, evidence gaps
MeSH terms
Autism Spectrum Disorder, Atomoxetine Hydrochloride, Animals, Attention Deficit Disorder with Hyperactivity, Brain, Humans, Melatonin, Methylphenidate, Psychopharmacology, Sleep Wake Disorders, Guanfacine, Consensus

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