Skip to main content

Advertisement

Log in

Medication treatment in subjects with autistic spectrum disorders

  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Autism is a pervasive developmental disorder that is aetiologically and clinically heterogeneous. Twin and family genetic studies provide evidence for strong genetic components. An international consortium using an affected sib pair strategy has found a promising linkage to a region on chromosome 7. In 10–15% of the cases autism is due to associated medical conditions that affect normal brain functioning. Post-mortem studies on small case series report cellular abnormalities in the limbic system and cerebellum. Between 10 and 20% of subjects with autism have macrocephalia, which is in accordance with MRI findings of an increased total brain tissue volume and enlargement most prominent in the occipital and parietal lobes. The most robust and well-replicated neurobiological abnormality in autism is an elevation of whole blood serotonin found in over 30% of the patients. Pharmacological interventions with serotonin reuptake blockers or with atypical neuroleptics that block both dopamine (D2) and serotonin (5-HT2) receptors seem to offer clinical benefit and merit further study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aman MG, Marks RE, Turbott SH, Wilsher CP, Merry SN (1991) Clinical effects of methylphenidate and thioridazine in intellectually subaverage children. Journal of the American Academy of Child and Adolescent Psychiatry 30: 246–256

    CAS  PubMed  Google Scholar 

  2. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV). APA, Washington D.C.

    Google Scholar 

  3. Anderson GM, Horne WC, Chatterjee D, Cohen DJ (1990) The hyperserotonemia of autism. Annals of the New York Academy of Science 600: 331–342

    Article  CAS  Google Scholar 

  4. Anderson LT, Campbell M, Adams P, Small AM, Perry R, Shell J (1989) The effects of haloperidol on discrimination learning and behavioral symptoms in autistic children. Journal of Autism and Developmental Disorders 19: 227–239

    Article  CAS  PubMed  Google Scholar 

  5. Anderson LT, Campbell M, Graga DM, Perry R, Small AM, Green WH (1984) Haloperidol in the treatment of infantile autism: effects on learning and behavioral symptoms. American Journal of Psychiatry 141: 1195–1202

    CAS  PubMed  Google Scholar 

  6. Bailey A, Le Couteur A, Gottesman I, Bolton P, Simonoff, E, Yuzda E, Rutter M (1995) Autism as a strongly genetic disorder: evidence from a British twin study. Psychological Medicine 25: 63–77

    Article  CAS  PubMed  Google Scholar 

  7. Bailey A, Luthert P, Dean A, Harding B, Janota I, Montgomery M, Rutter M, Lantos P (1998) A clinicopathological study of autism. Brain 121: 889–905

    Article  PubMed  Google Scholar 

  8. Bailey A, Phillips W, Rutter M (1996) Autism: towards an integration of clinical, genetic, neuropsychological, and neurobiological perspectives. Journal of Child Psychology and Psychiatry 37: 89–126

    Article  CAS  PubMed  Google Scholar 

  9. Bauman ML (1996) Brief report: neuroanatomic observations of the brain in pervasive developmental disorders. Journal of Autism and Developmental Disorders 26: 199–203

    Article  CAS  PubMed  Google Scholar 

  10. Bloom ASR (1988) Methylphenidate-induced delusional disorder in a child with attention deficit disorder with hyperactivity. Journal of the American Academy of Child and Adolescent Psychiatry 27: 88–89

    Article  CAS  PubMed  Google Scholar 

  11. Bolton P, Macdonald H, Pickles A, Rios P, Goode S, Crowson M, Bailey A, Rutter M (1994) A case-control family history study of autism. Journal of Child Psychology and Psychiatry 35: 877–900

    Article  CAS  PubMed  Google Scholar 

  12. Bolton PF, Griffiths PD (1997) Association of tuberous sclerosis of temporal lobes with autism and atypical autism [see comments]. Lancet 349: 392–395

    Article  CAS  PubMed  Google Scholar 

  13. Bolton PF, Murphy M, Macdonald H, Whitlock B, Pickles A, Rutter M (1997) Obstetric complications in autism: consequences or causes of the condition? Journal of the American Academy of Child and Adolescent Psychiatry 36: 272–281

    Article  CAS  PubMed  Google Scholar 

  14. Brodkin ES, McDougle CJ, Naylor ST, Cohen DJ, Price LH (1997) Clomipramine in adults with pervasive developmental disorders: a prospective openlabel investigation. Journal of Child and Adolescent Psychopharmacology 7: 109–121

    Article  CAS  PubMed  Google Scholar 

  15. Buitelaar JK (1993) Self-injurious behavior in retarded children, clinical phenomena and biological mechanisms. Acta Paedopsychiatrica 56: 105–111

    CAS  PubMed  Google Scholar 

  16. Buitelaar JK (1995) Attachment and social withdrawal in autism: hypotheses and findings. Behaviour 132: 319–350

    Article  Google Scholar 

  17. Buitelaar JK (1995) Psychopharmacological approaches to childhood psychotic disorders. In: Den Boer JA, Westenberg HGM, Van Praag HM (eds) Advances in the Neurobiology of Schizophrenia. Wiley & Sons, New York/London, pp 429–457

    Google Scholar 

  18. Buitelaar JK, Van der Gaag RJ (1998) Diagnostic rules for children with PDD-NOS and multiple complex developmental disorder. Journal of Child Psychology and Psychiatry 39: 911–920

    Article  CAS  PubMed  Google Scholar 

  19. Buitelaar JK, Van der Gaag RJ, Klin A, Volkmar F (1999) Exploring the boundaries of PDD-NOS: analyses of data from the DSM-IV autistic disorder field trial. Journal of Autism and Developmental Disorders 29: 33–43

    Article  CAS  PubMed  Google Scholar 

  20. Buitelaar JK, Van der Gaag RJ, Van der Hoeven J (1998) Effects of buspirone in the management of anxiety and irritability in children with pervasive developmental disorders: open pilot data. Journal of Clinical Psychiatry 59: 56–59

    CAS  PubMed  Google Scholar 

  21. Campbell M, Adams P, Perry R, Spencer EK, Overall JE (1988) Tardive and withdrawal dyskinesia in autistic children: a prospective study. Psychopharmacology Bulletin 24: 251–255

    CAS  PubMed  Google Scholar 

  22. Campbell M, Anderson LT, Small AM, Adams P, Gonzalez NM, Ernst M (1993) Naltrexone in autistic children — behaviornal symptoms and attentional learning. Journal of the American Academy of Child and Adolescent Psychiatry 32: 1283–1291

    Article  CAS  PubMed  Google Scholar 

  23. Campbell M, Fish B, David R, Shapiro T, Collins P, Koh C (1972) Response to triiodothyronine and dextroamphetamine: a study of preschool schizophrenic children. Journal of Autism and Childhood Schizophrenia 2: 343–357

    Article  CAS  PubMed  Google Scholar 

  24. Chen RT, DeStephano F (1998) Vaccine adverse events; causal or coincidental? Lancet 351: 611–612

    Article  CAS  PubMed  Google Scholar 

  25. Chugani DC, Muzik O, Rothermel R, Behen M, Chakraborty P, Mangner T, da Silva EA, Chugani HT (1997) Altered serotonin synthesis in the dentatothalam-ocortical pathway in autistic boys. Annals of Neurology 42: 666–669

    Article  CAS  PubMed  Google Scholar 

  26. Cohen DJ, Caparulo BK, Shaywitz BA, Bowers MB (1977) Dopamine and serotonin metabolism in neuropsychiatrically disturbed children: CSF homovanillic acid and 5-hydroxy-indoleacetic acid. Archives of General Psychiatry 34: 545–550

    CAS  PubMed  Google Scholar 

  27. Cook EH, Leventhal BL (1996) The serotonin system in autism. Current Opinion in Pediatrics 8: 348–354

    Article  CAS  PubMed  Google Scholar 

  28. Cook EH, Rowlett R, Jaselskis C, Leventhal BL (1992) Fluoxetine treatment of children and adults with autistic disorder and mental retardation. Journal of the American Academy of Child and Adolescent Psychiatry 31: 739–745

    Article  PubMed  Google Scholar 

  29. Cook EH Jr, Courchesne R, Lord C, Cox NJ, Yan S, Lincoln A, Haas R, Courchesne E, Leventhal BL (1997) Evidence of linkage between the serotonin transporter and autistic disorder. Molecular Psychiatry 2: 247–250

    Article  PubMed  Google Scholar 

  30. Cook EHJ, Leventhal BL, Heller W, Metz J, Wainwright M, Freedman DX (1990) Autistic children and their first-degree relatives: relationships between serotonin and norepinephrine levels and intelligence. Journal of Neuropsychiatry and Clinical Neuroscience 2: 268–274

    Google Scholar 

  31. Courchesne E, Saitoh O, Townsend JP, Yeung-Courchesne R, Press GA, Lincoln AJ, Haas RH, Schreibman L (1994) Cerebellar hypoplasia and hyperplasia in infantile autism. Lancet 343: 63–64

    Article  CAS  PubMed  Google Scholar 

  32. Courchesne E, Yeung-Courchesne R, Press GA, Hesselink JR, Jernigan, TL (1988) Hypoplasia of cerebellar vermal lobules VI and VII in autism. New England Journal of Medicine 318: 1349–1354

    CAS  PubMed  Google Scholar 

  33. Cuccaro ML, Wright HH, Abramson RK, Marsteller FA, Valentine J (1993) Whole blood serotonin and cognitive functioning in autistic individuals and their firstdegree relatives. Journal of Neuropsychiatry and Clinical Neuroscience 2: 268–274

    Google Scholar 

  34. D’Eufeinia P (1996) Abnormal intestinal permeability in children with autism. Acta Paediatrica 85: 1076–1079

    Article  Google Scholar 

  35. Ernst M, Magee HJ, Gonzalez NM, Locascio JJ, Rosenberg CR, Campbell M (1992) Pimozide in autistic children. Psychopharmacology Bulletin 28: 187–191

    CAS  PubMed  Google Scholar 

  36. Ernst M, Zametkin AJ, Matochik JA, Pascualvaca D, Cohen RM (1997) Low medial prefrontal dopaminergic activity in autistic children [letter]. Lancet 350: 638

    Article  CAS  PubMed  Google Scholar 

  37. Fankhauser MP, Karumanchi VC, German ML, Yates A, Karumanchi SD (1992) A double-blind, placebo-controlled study of the efficacy of transdermal clonidine in autism. Journal of Clinical Psychiatry 53: 77–82

    CAS  PubMed  Google Scholar 

  38. Filipek PA (1996) Brief report: neuroimaging in autism: the state of the science 1995. Journal of Autism and Developmental Disorders 26: 211–215

    Article  CAS  PubMed  Google Scholar 

  39. Findling RL, Maxwell K, Wiznitzer M (1997) An open clinical trial of risperidone monotherapy in young children with autistic disorder. Psychopharmacology Bulletin 33: 155–159

    CAS  PubMed  Google Scholar 

  40. Fisman S, Steele M (1996) Use of risperidone in pervasive developmental disorders: a case series. Journal of Child and Adolescent Psychopharmacology 6: 177–190

    Article  CAS  PubMed  Google Scholar 

  41. Folstein S, Rutter ML (1977) Infantile autism: a genetic study of 21 twin pairs. Journal of Child Psychology and Psychiatry 18: 297–312

    Article  CAS  PubMed  Google Scholar 

  42. Freeman WJ (1997) Neurohumoral brain dynamics of social group formation. Implications for autism. Annals of the New York Academy of Science 807: 501–503

    Article  CAS  Google Scholar 

  43. Garreau B, Barthélémy C, Jouve J, Bruneau N, Muh JP, Lelord G (1988) Urinary homovanillic acid levels of autistic children. Developmental Medicine and Child Neurology 30: 93–98

    Article  CAS  PubMed  Google Scholar 

  44. Geller E, Ritvo ER, Freeman BJ (1982) Preliminary observations on the effects of fenfluramine on blood serotonin and symptoms in three autistic boys. New England Journal of Medicine 307: 165–169

    Article  CAS  PubMed  Google Scholar 

  45. Geller WK, Zuiderwijk PB (1998) Risperidone-induced hepatotoxicity? [letter]. Journal of the American Academy of Child and Adolescent Psychiatry 37: 246–247

    Article  CAS  PubMed  Google Scholar 

  46. Gillberg C (1991) The treatment of epilepsy in autism. Journal of Autism and Developmental Disorders 21: 61–77

    Article  CAS  PubMed  Google Scholar 

  47. Gillberg C, Svennerholm L (1987) CSF monoamines in autistic syndromes and other pervasive developmental disorders of early childhood. British Journal of Psychiatry 151: 89–94

    Article  CAS  PubMed  Google Scholar 

  48. Gillberg C, Svennerholm L, Hamilton-Hellberg C (1983) Childhood psychosis and monoamine metabolites in spinal fluid. Journal of Autism and Developmental Disorders 13: 383–396

    Article  CAS  PubMed  Google Scholar 

  49. Gordon CT, State RC, Nelson JE, Hamburger SD, Rapoport JL (1993) A doubleblind comparison of clomipramine, desipramine, and placebo in the treatment of autistic disorder. Archives of General Psychiatry 50: 441–447

    CAS  PubMed  Google Scholar 

  50. Hameury L, Roux S, Barthelemy C, Adrien JL, Desombre H, Sauvage D, Garreau B, Lelord G (1995) Quantified multidimensional assessment of autism and other pervasive developmental disorders. Application for bioclinical research. European Child and Adolescent Psychiatry 4: 123–135

    Article  CAS  PubMed  Google Scholar 

  51. Happe F, Frith U (1996) The neuropsychology of autism. Brain 119: 1377–1400

    Article  PubMed  Google Scholar 

  52. Hardan A, Johnson K, Johnson C, Hrecznyj B (1996) Case study: risperidone treatment of children and adolescents with developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry 35: 1551–1556

    Article  CAS  PubMed  Google Scholar 

  53. Hashimoto T, Tayama M, Miyazaki M, Akurama N, Yoshioto T, Murakawa K, Kuroda Y (1992) Reduced brainstem size in children with autism. Brain and Development 14: 94–97

    CAS  PubMed  Google Scholar 

  54. Hashimoto T, Tayama M, Miyazaki M, Murakawa K, Kuroda Y (1993) Brainstem and cerebellar vermis involvement in autistic children. Journal of Child Neurology 8: 149–152

    Article  CAS  PubMed  Google Scholar 

  55. Hashimoto T, Tayama M, Murakawa K, Yoshimoto T, Miyake H, Harada M, Kuroda Y (1995) Development of the brainstem and cerebellum in autistic patients. Journal of Autism and Developmental Disorders 25: 1–18

    Article  CAS  PubMed  Google Scholar 

  56. Hellings JA, Kelley LA, Gabrielli WF, Kilgore E, Shah P (1996) Sertraline response in adults with mental retardation and autistic disorder, Journal of Clinical Psychiatry 57: 333–336

    CAS  PubMed  Google Scholar 

  57. Herault J, Petit E, Martineau J, Cherpi C, Perrot A, Barthelemy C, Lelord G, Muh JP (1996) Serotonin and autism: biochemical and molecular biology features. Psychiatry Research 65: 33–43

    Article  CAS  PubMed  Google Scholar 

  58. Horvath K, Stefanatos G, Sokolski K, Wachtel R, Nabors L, Tildon JT (1998) Improved social and language skills after secretin administration in patients with autistic spectrum disorders. Journal of the Association for Academic Minority Physicians 9: 9–15

    CAS  PubMed  Google Scholar 

  59. Hoshino Y, Tachibana R, Watanabe M, Murata S, Yokoyama F, Kaneko M, Yashima Y, Kumoshiro H (1984) Serotonin metabolism and hypothalamic-pituitary function in children with infantile autism and minimal brain dysfunction. Japanese Journal of Psychiatry and Neurology 26: 937–945

    Google Scholar 

  60. Howlin P (1993) Behavioural techniques to reduce self-injurious behaviour in children with autism. Acta Paedopsychiatrica 56: 75–84

    CAS  PubMed  Google Scholar 

  61. Howlin P (1998) Practitioner review: psychological and educational treatments for autism Journal of Child Psychology and Psychiatry 39: 307–322

    Article  CAS  PubMed  Google Scholar 

  62. Howlin P, Rutter M (1987) Treatment of Autistic Children. Wiley & Sons, Chichester/New York

    Google Scholar 

  63. Hsu M, Yeung-Courchesne R, Courchesne E, Press GA (1991) Absence of magnetic resonance imaging evidence of pontine abnormality in infantile autism. Archives of Neurology 48: 1160–1163

    CAS  PubMed  Google Scholar 

  64. Insel TR (1997) A neurobiological basis of social attachment. American Journal of Psychiatry 154: 726–735

    CAS  PubMed  Google Scholar 

  65. International Molecular Genetic Study of Autism Consortium (1998) A full genome screen for autism with evidence for linkage to a region on chromosome 7q. Human Molecular Genetics 7: 571–578

    Article  CAS  Google Scholar 

  66. Kemper TL, Bauman ML (1993) The contribution of neuropathologic studies to the understanding of autism. Behavioural Neurology 11: 175–187

    CAS  Google Scholar 

  67. Kerbeshian J, Burd L, Fisher W (1987) Lithium carbonate in the treatment of two patients with infantile autism and atypical bipolar symptomatology. Journal of Clinical Psychopharmacology 7: 401–405

    CAS  PubMed  Google Scholar 

  68. Klauck SM, Poustka F, Benner A, Lesch KP, Poustka A (1997) Serotonin transporter (5-HTT) gene variants associated with autism? Human Molecular Genetics 6: 2233–2238

    Article  CAS  PubMed  Google Scholar 

  69. Kolmen BK, Feldman HM, Handen BL Janosky JE (1995) Naltrexone in young autistic children — a double-blind, placebo-controlled crossover study, Journal of the American Academy of Child and Adolescent Psychiatry 34: 223–231

    Article  CAS  PubMed  Google Scholar 

  70. Kolmen BK, Feldman HM, Handen BL, Janosky JE (1997) Naltrexone in young autistic children: replication study and learning measures. Journal of the American Academy of Child and Adolescent Psychiatry 36: 1570–1578

    Article  CAS  PubMed  Google Scholar 

  71. Komoto JM, Usui S, Hirata J (1984) Infantile autism and affective disorder. Journal of Autism and Developmental Disorders 14: 81–84

    Article  CAS  PubMed  Google Scholar 

  72. Kumra S, Herion D, Jacobsen LK, Briguglia C, Grothe D (1997) Case study: risperidone-induced hepatotoxicity in pediatric patients. Journal of the American Academy of Child and Adolescent Psychiatry 36: 701–705

    Article  CAS  PubMed  Google Scholar 

  73. Lainhart JE, Piven J, Wzorek M, Landa R, Santangelo SL, Coon H, Folstein SE (1997) Macrocephaly in children and adults with autism. Journal of the American Academy of Child and Adolescent Psychiatry 36: 282–290

    Article  CAS  PubMed  Google Scholar 

  74. Launay JM, Bursztejn C, Ferrari P, Dreux C, Braconnier A, Zarifian E, Lancrenon S, Fermanian J (1987) Catecholamine metabolism in infantile autism: a controlled study of 22 autistic children. Journal of Autism and Developmental Disorders 17: 553–556

    Article  Google Scholar 

  75. Leboyer M, Bouvard MP, Launay J, Tabuteau F, Waller D, Dugas M, Kerdelhue B, Lensing P, Panksepp J (1992) Brief report: a double-blind study of naltrexone in infantile autism. Journal of Autism and Developmental Disorders 22: 309–319

    Article  CAS  PubMed  Google Scholar 

  76. Lord C, Rutter M (1995) Autism and pervasive develomental disorders. In: Rutter M, Taylor E, Hersov L (eds) Child and Adolescent Psychiatry, Modern Approaches. Oxford. Blackwell Scientific Publications, pp 569–593

    Google Scholar 

  77. Martineau J, Herault J, Petit E, Guerin P, Hameury L, Perrot A, Mallet J, Sauvage D, Lelord G, Muh JP (1994) Catecholaminergic metabolism and autism. Journal of Autism and Developmental Disorders 36: 688–697

    CAS  Google Scholar 

  78. McBride PA, Anderson GM, Hertzig ME, Snow ME, Thompson SM, Khait VD, Shapiro T, Cohen DJ (1998) Effects of diagnosis, race, and puberty on platelet serotonin levels in autism and mental retardation. Journal of the American Academy of Child and Adolescent Psychiatry 37: 767–776

    Article  CAS  PubMed  Google Scholar 

  79. McBride PA, Anderson GM, Hertzig ME, Sweeney JA, Kream J, Cohen DJ, Mann JJ (1989) Serotonergic responsivity in male young adults with autistic disorder. ARchives of General Psychiatry 46: 213–221

    CAS  PubMed  Google Scholar 

  80. McDougle CJ (1998) Psychopharmacology of autism (paper presented at XIth Congress of the ECNP). European Neuropsychopharmacology (suppl 2): S107

    Article  Google Scholar 

  81. McDougle CJ, Holmes JP, Bronson MR, Anderson GM, Volkmar FR, Price LH, Cohen DJ (1997) Risperidone treatment of children and adolescents with pervasive developmental disorders: a prospective open-label study. Journal of the American Academy of Child and Adolescent Psychiatry 36: 685–693

    Article  CAS  PubMed  Google Scholar 

  82. McDougle CJ, Holmes JP, Carlson DC, Pelton GH, Cohen DJ, Price LH (1998) A double-blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders [see comments]. Archives of General Psychiatry 55: 633–641

    Article  CAS  PubMed  Google Scholar 

  83. McDougle CJ, Naylor ST, Cohen DJ, Aghajanian GK, Heninger GR, Price LH (1996) Effects of tryptophan depletion in drug-free adults with autistic disorder [see comments]. Archives of General Psychiatry 53: 993–1000

    CAS  PubMed  Google Scholar 

  84. McDougle CJ, Naylor ST, Cohen DJ, Volkmar FR, Heninger GR, Price LH (1996) A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Archives of General Psychiatry 53: 1001–1008

    CAS  PubMed  Google Scholar 

  85. McDougle CJ, Price LH, Volkmar FR, Goodman WK, Ward-O’Brien D, Nielsen J, Bregman J, Cohen DJ (1992) Clomipramine in autism: preliminary evidence of efficacy (case study), Journal of the American Academy of Child and Adolescent Psychiatry 31: 746–750

    Article  CAS  PubMed  Google Scholar 

  86. Minderaa RB, Anderson GM, Volkmar FR, Akkerhuis GW, Cohen DJ (1989) Neurochemical study of dopamine functioning in autistic and normal subjects. Journal of the American Academy of Child and Adolescent Psychiatry 28: 190–194

    Article  CAS  PubMed  Google Scholar 

  87. Minderaa RB, Anderson GM, Volkmar FR, Harcherick D, Akkerhuis GW, Cohen DJ (1989) Whole blood serotonin and tryptophan in autism: temporal stability and the effects of medication. Journal of Autism and Developmental Disorders 19: 129–136

    Article  CAS  PubMed  Google Scholar 

  88. Minshew NJ, Goldstein G, Dombrowski SM, Panchalingam K, Pettegrew JW (1993) A preliminary 31P MRS study of autism: evidence for undersynthesis and increased degradation of brain membranes. Biological Psychiatry 33: 762–773

    Article  CAS  PubMed  Google Scholar 

  89. Modahl C, Green L, Fein D, Morris M, Waterhouse L, Feinstein C, Levin H (1998) Plasma oxytocin levels in autistic children. Biological Psychiatry 43: 270–277

    Article  CAS  PubMed  Google Scholar 

  90. Narayan M, Srinath S, Anderson GM, Meundi DB (1993) Cerebrospinal fluid levels of homovanillic acid and 5-hydroxyindoleacetic acid in autism. Biological Psychiatry 33: 630–635

    Article  CAS  PubMed  Google Scholar 

  91. Naruse H, Nagahata M, Nakane Y, Shirahashi K, Takesada M, Yamazaki K (1982) A multi-center double-blind trial of pimozide (Orap), haloperidol and placebo in children with behavioral disorders, using cross-over design. Acta Paedopsychiatrica 48: 173–184

    CAS  PubMed  Google Scholar 

  92. Nicolson R, Awad G, Sloman L (1998) An open trial of risperidone in young autistic children. Journal of the American Academy of Child and Adolescent Psychiatry 37: 372–376

    Article  CAS  PubMed  Google Scholar 

  93. Panksepp J (1979) A neurochemical theory of autism. Trends in Neuroscience 2: 174–177

    Article  Google Scholar 

  94. Partington MW, Tu JB, Wong CY (1973) Blood serotonin levels in severe mental retardation Developmental Medicine and Child Neurology 15: 616–627

    Article  CAS  PubMed  Google Scholar 

  95. Perry R, Campbell M, Adams P, Lynch N, Spencer EK, Curren EL, Overall JE (1989) Long-term efficacy of haloperidol in autistic children: continuous versus discontinuous administration. Journal of the American Academy of Child and Adolescent Psychiatry 28: 87–92

    Article  CAS  PubMed  Google Scholar 

  96. Perry R, Pataki C, Munoz Silva DM, Armenteros J, Silva RR (1997) Risperidone in children and adolescents with pervasive developmental disorder: pilot trial and follow-up. Journal of Child and Adolescent Psychopharmacology 7: 167–179

    Article  CAS  PubMed  Google Scholar 

  97. Pickles A, Bolton P, Macdonald H, Bailey A, Le Couteur A, Sim CH, Rutter M (1995) Latent-class analysis of recurrence risks for complex phenotypes with selection and measurement error: a twin and family history study of autism. American Journal of Human Genetics 57: 717–726

    CAS  PubMed  Google Scholar 

  98. Piven J, Arndt S, Bailey J, Andreasen N (1996) Regional brain enlargement in autism: a magnetic resonance imaging study. Journal of the American Academy of Child and Adolescent Psychiatry 35: 530–536

    Article  CAS  PubMed  Google Scholar 

  99. Piven J, Arndt S, Bailey J, Havercamp S, Andreasen NC, Palmer P (1995) An MRI study of brain size in autism. American Journal of Psychiatry 152: 1145–1149

    CAS  PubMed  Google Scholar 

  100. Piven J, Bailey J, Ranson BJ, Arndt S (1997) An MRI study of the corpus callosum in autism. American Journal of Psychiatry 154: 1051–1056

    CAS  PubMed  Google Scholar 

  101. Piven J, Berthier ML, Starkstein SE, Nehme E, Pearlson G, Folstein S (1990) Magnetic resonance imaging evidence for a defect of cerebral cortical development in autism. American Journal of Psychiatry 147: 734–739

    CAS  PubMed  Google Scholar 

  102. Piven J, Nehme E, Barta P, Pearlson G, Folstein SE (1992) Magnetic resonance imaging in autism: measurement of the cerebellum, pons, and fourth ventricle. Biological Psychiatry 31: 491–504

    Article  CAS  PubMed  Google Scholar 

  103. Piven J, Saliba K, Bailey J, Arndt S (1997) An MRI study of autism: the cerebellum revisited. Neurology 49: 546–551

    CAS  PubMed  Google Scholar 

  104. Plioplys A (1994) Autism: electroen-cephalographic abnormalities and clinical improvement with valproic acid. Archives of Pediatric and Adolescent Medecine 148: 220–222

    CAS  Google Scholar 

  105. Quintana H, Birmaher B, Stedge D, Lennon S, Freed J, Bridge J, Greenhill L (1995) Use of methylphenidate in the treatment of children with autistic disorder. Journal of Autism and Developmental Disorders 25: 283–294

    Article  CAS  PubMed  Google Scholar 

  106. Ratey J, Sovner R, Parks A, Rogentine K (1991) Buspirone treatment of aggression and anxiety in mentally retarded patients: a multiple-baseline, placebo lead-in study. Journal of Clinical Psychiatry 52: 159–162

    CAS  PubMed  Google Scholar 

  107. Ratey JJ, Bemporad J, Sorgi P, Bick P, Polakoff S, O’Driscoll G, Mikkelsen E (1987) Brief report: open trial effects of beta-blockers on speech and social behaviors in 8 autistic adults. Journal of Autism and Developmental Disorders 17: 439–446

    Article  CAS  PubMed  Google Scholar 

  108. Ratey JJ, Lindem KJ (1991) Beta-blockers as primary treatment for aggression and self-injury in the developmentally disabled. In: Ratey JJ (eds) Mental Retardation. Developing Pharmacotherapies. American Psychiatric Press, Inc. Washington DC, pp 51–82

    Google Scholar 

  109. Ratey JJ, Sovner R, Mikkelsen E, Chmielinski HE (1989) Buspirone therapy for maladaptive behavior and anxiety in developmentally disabled persons. Journal of Clinical Psychiatry 50: 382–384

    CAS  PubMed  Google Scholar 

  110. Realmuto GM, August GJ, Garfinkel BD (1989) Clinical effect of buspirone in autistic children. Journal of Clinical Psychopharmacology 9: 122–125

    Article  CAS  PubMed  Google Scholar 

  111. Realmuto GM, Jensen J, Klykylo W, Piggott L, Stubbs B, Yuwiler A, Geller E, Freeman BJ, Ritvo E (1986) Untoward effects of fenfluramine in autistic children. Journal of Clinical Psychopharmacology 6: 350–355

    Article  CAS  PubMed  Google Scholar 

  112. Riddle M (1996) Fluvoxamine in Children and Adolescents with OCD. Proceedings X World Congress of Psychiatry, Madrid 2: 141

  113. Ritvo ER, Freeman BJ, Geller E, Yuwiler A (1983) Effects of fenfluramine on 14 outpatients with the syndrome of autism. Journal of the American Academy of Child Psychiatry 22: 549–558

    Article  CAS  PubMed  Google Scholar 

  114. Ross DL, Klykylo WM, Anderson GM (1985) Cerebrospinal fluid indolamines and monoamine effects in fenfluramine treatment of autism. Annals of Neurology 18: 394–396

    Google Scholar 

  115. Rutter M, Bailey A, Bolton P, Le Couteur A (1994) Autism and known medical conditions: myth and substance. Journal of Child Psychology and Psychiatry 35: 311–322

    Article  CAS  PubMed  Google Scholar 

  116. Sanchez LE, Campbell M, Small AM, Cueva JE, Armenteros JL, Adams PB (1996) A pilot study of clomipramine in young autistic children. Journal of the American Academy of Child and Adolescent Psychiatry 35: 537–544

    Article  CAS  PubMed  Google Scholar 

  117. Sandler AD, Sutton KA, DeWeese J, Girardi MA, Sheppard V, Bodfish JW (1999) Lack of benefit of a single dose of synthetic human secretin in the treatment of autism and pervasive developmental disorder. New England Journal of Medicine 341: 1801–1806

    Article  CAS  PubMed  Google Scholar 

  118. Schuster CR, Lewis M, Seiden LS (1986) Fenfluramine: neurotoxicity. Psychopharmacology Bulletin 22: 148–151

    CAS  PubMed  Google Scholar 

  119. Smalley SL (1997) Genetic influences in childhood-onset psychiatric disorders: autism and attention-deficit/hyperactivity disorder. American Journal of Human Genetics 60: 1276–1282

    Article  CAS  PubMed  Google Scholar 

  120. Steffenburg S, Gillberg C, Hellgren L, Anderson L, Gillberg IC, Jakobsson G, Bohman M (1989) A twin study of autism in Denmark, Finland, Iceland, Norway and Sweden. Journal of Child Psychology and Psychiatry 30: 405–416

    Article  CAS  PubMed  Google Scholar 

  121. Taylor B, Miller E, Farrington CP, Petropoulos M, Favot-Mayaud I, Li J, Waight PA (1999) Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet 353: 2026–2029

    Article  CAS  PubMed  Google Scholar 

  122. Tordjman S, Anderson GM, McBride PA, Hertzig ME, Snow ME, Hall LM, Thompson SM, Ferrari P, Cohen DJ (1997) Plasma beta-endorphin, adrenocorticotropic hormone, and cortisol in autism. Journal of Child Psychology and Psychiatry 38: 705–715

    Article  CAS  PubMed  Google Scholar 

  123. Volkmar FR (1999) Lessons from secretin. New England Journal of Medicine 341: 1842–1844

    Article  CAS  PubMed  Google Scholar 

  124. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA (1998) Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children [see comments]. Lancet 351: 637–641

    Article  CAS  PubMed  Google Scholar 

  125. Willemsen-Swinkels SHN, Buitelaar JK, Nijhof G, Van Engeland H (1995) Failure of naltrexone hydrochloride to reduce self-injurious and autistic behavior in mentally retarded adults. Double-blind place bo-controlled studies. Archives of General Psychiatry 52: 766–773

    CAS  PubMed  Google Scholar 

  126. Willemsen-Swinkels SHN, Buitelaar JK, Van Berckelaer-Onnes IA, Van Engeland H (1999) Six-months continuation treatment of naltrexone-responsive children with autism: an open-label case-control design. Journal of Autism and Developmental Disorders 29: 167–169

    Article  CAS  PubMed  Google Scholar 

  127. Willemsen-Swinkels SHN, Buitelaar JK, Van Engeland H (1996) The effects of chronic naltrexone treatment in young autistic children: a double-blind place bo-controlled crossover study. Biological Psychiatry 39: 1023–1031

    Article  CAS  PubMed  Google Scholar 

  128. Willemsen-Swinkels SHN, Buitelaar JK, Weijnen FG, Thijssen JHH, Van Engeland H (1996) Plasma beta-endorphin concentrations in people with learning disability and self-injurious and/or autistic behaviour. British Journal of Psychiatry 168: 105–109

    Article  CAS  PubMed  Google Scholar 

  129. Willemsen-Swinkels SHN, Buitelaar JK, Weijnen FG, Van Engeland H (1995) Placebo-controlled acute dosage naltrexone study in young autistic children. Psychiatry Research 58: 203–215

    Article  CAS  PubMed  Google Scholar 

  130. Woodhouse W, Bailey A, Rutter M, Bolton P, Baird G, Le Couteur A (1996) Head circumference in autism and other pervasive developmental disorders. Journal of Child Psychology and Psychiatry 37: 665–671

    Article  CAS  PubMed  Google Scholar 

  131. World Health Organization (WHO) (1992) ICD-10. Classification of Mental and Behavioural Disorders. Clinical Description and Diagnostic Guidelines. WHO, Geneve

  132. Zilbovicius M, Garreau B, Samson Y, Remy P, Barthelemy C, Syrota A, Lelord G (1995) Delayed maturation of the frontal cortex in childhood autism. American Journal of Psychiatry 152: 248–252

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jan K. Buitelaar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Buitelaar, J.K., Willemsen-Swinkels, S.H.N. Medication treatment in subjects with autistic spectrum disorders. European Child & Adolescent Psychiatry 9 (Suppl 1), S85–S97 (2000). https://doi.org/10.1007/s007870070022

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s007870070022

Key words

Navigation