The DOI matches its Crossref record; 63 of the 63 references it cites were found in a registry or an index.
Pharmacologic Treatment of Severe Irritability and Problem Behaviors in Autism: A Systematic Review and Meta-analysis
Abstract
BACKGROUND: Autism spectrum disorder (ASD) is increasingly recognized as a public health issue. Irritability and aggression (IA) often negatively affect the lives of people with ASD and their families. Although many medications have been tested for IA in ASDs in randomized controlled trials (RCTs), critical quantitative analyses of these trials are lacking in the literature. OBJECTIVES: To systematically review and quantitatively analyze the efficacy and safety of pharmacologic treatments for IA in youth with ASD. DATA SOURCES: Studies were identified from Medline, PsycINFO, Embase, and review articles. METHODS: Original articles on placebo-controlled RCTs of pharmacologic treatments of IA in youth age 2 to 17 years with ASD were included. Data items included study design, study goals, details of study participants, details of intervention, study results, statistical methods, side effects, and risks of bias. The primary study outcome measure was the effect size of reduction in the Aberrant Behavioral Checklist–Irritability (ABC-I) scores in the medication group, as compared with placebo, in RCTs using parallel groups design. RESULTS: Forty-six RCTs were identified. Compared with placebo, 3 compounds resulted in significant improvement in ABC-I at the end of treatment. Risperidone and aripiprazole were found to be the most effective, with the largest effect sizes. Sedation, extrapyramidal sides effects, and weight gain were assessed quantitatively. CONCLUSIONS: Although risperidone and aripiprazole have the strongest evidence in reducing ABC-I in youth with ASD, a few other compounds also showed significant efficacy with fewer potential side effects and adverse reactions in single studies.
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“one meta-analysis on pharmacological treatment of irritability and problem behaviors in ASD did report that the number of subjects needed to treat was lower for risperidone [138].”
From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [138]
Citations
Cites
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GRADE guidelines: 3. Rating the quality of evidence
Balshem, H., Helfand, M., Schünemann, H. J., Oxman, A. D., Kunz, R., Brozek, J., Vist, G. E., Falck-Ytter, Y., Meerpohl, J., & Norris, S. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.07.015 · Cited by 8,285
Dysfunction in the neural circuitry of emotion regulation–a possible prelude to violence
Davidson, R. J., Putnam, K. M., & Larson, C. L. (2000) · Science · doi:10.1126/science.289.5479.591 · Cited by 1,894
Risperidone in Children with Autism and Serious Behavioral Problems
McCracken, J. T., McGough, J., Shah, B., Cronin, P., Hong, D., Aman, M. G., Arnold, L. E., Lindsay, R., Nash, P., Hollway, J., et al. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa013171 · Cited by 1,574
Correll, C. U. (2009) · JAMA · doi:10.1001/jama.2009.1549 · Cited by 1,050
Neurobiology of Aggression and Violence
Siever, L. J. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.07111774 · Cited by 984
Emotion-Related Regulation: Sharpening the Definition
Eisenberg, N., & Spinrad, T. L. (2004) · Child Development · doi:10.1111/j.1467-8624.2004.00674.x · Cited by 915
Research works printed but not linked: 1
- Vorvick, 2009, Irritability
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Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31129-2 · Cited by 2,819
Self-citationIdentification, Evaluation, and Management of Children With Autism Spectrum Disorder
Hyman, S. L., Levy, S. E., Myers, S. M., COUNCIL ON CHILDREN WITH DISABILITIES, S. O. D. A. B. P., Kuo, D. Z., Apkon, S., Davidson, L. F., Ellerbeck, K. A., Foster, J. E. A., Noritz, G. H., et al. (2020) · Pediatrics · doi:10.1542/peds.2019-3447 · Cited by 1,798
The Lancet Commission on the future of care and clinical research in autism
Lord, C., Charman, T., Havdahl, A., Carbone, P., Anagnostou, E., Boyd, B., Carr, T., de Vries, P. J., Dissanayake, C., Divan, G., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)01541-5 · Cited by 924
Co-occurring psychiatric conditions in autism spectrum disorder
Rosen, T. E., Mazefsky, C. A., Vasa, R. A., & Lerner, M. D. (2018) · International Review of Psychiatry · doi:10.1080/09540261.2018.1450229 · Cited by 325
Solmi, M., Fornaro, M., Ostinelli, E. G., Zangani, C., Croatto, G., Monaco, F., Krinitski, D., Fusar‐Poli, P., & Correll, C. U. (2020) · World Psychiatry · doi:10.1002/wps.20765 · Cited by 324
Metadata
- Authors
- Fung, L. K., Mahajan, R., Nozzolillo, A., Bernal, P., Krasner, A., Jo, B., Coury, D., Whitaker, A., Veenstra-Vanderweele, J., & Hardan, A. Y.
- Affiliations
- Stanford University (US)
- Kennedy Krieger Institute (US)
- Massachusetts General Hospital (US)
- Kaiser Permanente Northern California (US)
- NewYork–Presbyterian Hospital (US)
- The Ohio State University (US)
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2016-02-01
- Volume
- 137
- Issue
- Supplement_2
- Pages
- S124-S135
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2280843891
- Cited by
- 294
- References
- 63
- Citations by year
- 2026: 18 · 2025: 25 · 2024: 27 · 2023: 34 · 2022: 34 · 2021: 49 · 2020: 44 · 2019: 24 · 2018: 21 · 2017: 11 · 2016: 7
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- autism spectrum disorder, irritability, aggression, behavioral problems, pharmacotherapy, risperidone, aripiprazole, adverse drug reactions, sedation, extrapyramidal symptoms, weight gain, youth
- MeSH terms
- Problem Behavior, Autism Spectrum Disorder, Aripiprazole, Adolescent, Child, Child Development Disorders, Pervasive, Child, Preschool, Humans, Irritable Mood, Antipsychotic Agents, Self-Injurious Behavior, Risperidone
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