TY - JOUR
T1 - Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology
T2 - Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology
AU - Howes, Oliver D
AU - Rogdaki, Maria
AU - Findon, James L
AU - Wichers, Robert H
AU - Charman, Tony
AU - King, Bryan H
AU - Loth, Eva
AU - McAlonan, Gráinne M
AU - McCracken, James T
AU - Parr, Jeremy R
AU - Povey, Carol
AU - Santosh, Paramala
AU - Wallace, Simon
AU - Simonoff, Emily
AU - Murphy, Declan G
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - Journal Article
UR - http://www.scopus.com/inward/record.url?scp=85040776504&partnerID=8YFLogxK
U2 - 10.1177/0269881117741766
DO - 10.1177/0269881117741766
M3 - Article
C2 - 29237331
SN - 0269-8811
VL - 32
SP - 3
EP - 29
JO - Journal of Psychopharmacology
JF - Journal of Psychopharmacology
IS - 1
M1 - 269881117741766
ER -