Two systematic reviews find little evidence for drug treatments in children under 12 with autism spectrum disorders

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Around 1% of the population have autism. There are a number of treatments available for the condition, including learning and development techniques, as well as medical interventions. However, there is little consensus about which drug treatments are most effective.

A team of researchers from Nashville have recently published two systematic reviews in the Pediatrics journal, which investigate the effectiveness of various drug treatments for children aged 12 years and younger with autism spectrum disorders. The treatments studied include antipsychotics, antidepressants and the hormone therapy secretin.

Both reviews involved systematic literature searching of a range of databases over the last 10 years and independent assessment of which studies to include. Two reviewers independently extracted data from the included studies.

One review found evidence of benefit of risperidone and aripiprazole for challenging and repetitive behaviors, but it also found significant side effects of these drugs.

There was not enough evidence to come to any conclusions about the benefits or harms of serotonin-reuptake inhibitors and stimulant medications.

The authors concluded:

Although many children with autism spectrum disorders are currently treated with medical interventions, strikingly little evidence exists to support benefit for most treatments. Risperidone and aripiprazole have shown benefit for challenging and repetitive behaviors, but associated adverse effects limit their use to patients with severe impairment or risk of injury.

The other review found 7 randomised controlled trials that showed a lack of effectiveness of secretin for the treatment of autism symptoms including language and communication impairment, symptom severity, and cognitive and social skill deficits. They found no studies that showed secretin was any better than placebo in the treatment of autism.

The authors concluded:

Secretin has been studied extensively in multiple randomized controlled trials, and there is clear evidence that it lacks benefit. The studies of secretin included in this review uniformly point to a lack of significant impact of secretin in the treatment of autism spectrum disorder symptoms. Given the high strength of evidence for a lack of effectiveness, secretin as a treatment approach for autism spectrum disorders warrants no further study.

McPheeters ML, Warren Z, Sathe N, Bruzek JL, Krishnaswami S, Jerome RN, Veenstra-Vanderweele J. A systematic review of medical treatments for children with autism spectrum disorders. Pediatrics. 2011 May;127(5):e1312-21. Epub 2011 Apr 4. [PubMed abstract]

Krishnaswami S, McPheeters ML, Veenstra-Vanderweele J. A systematic review of secretin for children with autism spectrum disorders. Pediatrics. 2011 May;127(5):e1322-5. Epub 2011 Apr 4. [PubMed abstract]

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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