Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response

Gonzalo Salazar de Pablo; Carolina Pastor Jordá; Julio Vaquerizo-Serrano; Carmen Moreno; Anna Cabras; Celso Arango; Patricia Hernández; Jeremy Veenstra-VanderWeele; Emily Simonoff; Paolo Fusar-Poli; Paramala Santosh; Samuele Cortese; Mara Parellada

doi:10.1016/j.jaac.2022.03.033

Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response

Gonzalo Salazar de Pablo, Carolina Pastor Jordá, Julio Vaquerizo-Serrano, Carmen Moreno, Anna Cabras, Celso Arango, Patricia Hernández, Jeremy Veenstra-VanderWeele, Emily Simonoff, Paolo Fusar-Poli, Paramala Santosh, Samuele Cortese, Mara Parellada^*

^*Corresponding author for this work

University of Pittsburgh Medical Center, Pittsburgh; the Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania; and Hospital Universitario 12 de Octubre, Madrid, Spain
Hospital General Universitario Gregorio Marañón
Department of Environmental Biology Sapienza University of Rome Rome Italy
Department of Clinical Psychology; Columbia University; New York, NY USA; Trauma and PTSD Program; Columbia University; New York, NY USA; Department of Psychiatry; The New York State Psychiatric Institute; New York, NY USA.
Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom; University of Pavia, Italy, and OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
Centre for Innovation in Mental Health, Academic Unit of Psychology, Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, United Kingdom; the New York University Child Study Center, New York; and the Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, United Kingdom

Research output: Contribution to journal › Article › peer-review

31 Citations (Scopus)

Abstract

Objective: Emotional dysregulation and irritability are common in individuals with autism spectrum disorder (ASD). We conducted the first meta-analysis assessing the efficacy of a broad range of pharmacological interventions for emotional dysregulation and irritability in ASD and predictors of response. Method: Following a preregistered protocol (PROSPERO: CRD42021235779), we systematically searched multiple databases until January 1, 2021. We included placebo-controlled randomized controlled trials (RCTs) and evaluated the efficacy of pharmacological interventions and predictors of response for emotional dysregulation and irritability. We assessed heterogeneity using Q statistics and publication bias. We conducted subanalyses and meta-regressions to identify predictors of response. The primary effect size was the standardized mean difference. Quality of studies was assessed using the Cochrane Risk of Bias Tool (RoB2). Results: A total of 2,856 individuals with ASD in 45 studies were included, among which 26.7% of RCTs had a high risk of bias. Compared to placebo, antipsychotics (standardized mean difference = 1.028, 95% CI = 0.824-1.232) and medications used to treat attention-deficit/hyperactivity disorder (ADHD) (0.471, 0.061-0.881) were significantly better than placebo in improving emotional dysregulation and irritability, whereas evidence of efficacy was not found for other drug classes (p >.05). Within individual medications, evidence of efficacy was found for aripiprazole (1.179, 0.838-1.520) and risperidone (1.074, 0.818-1.331). Increased rates of comorbid epilepsy (β = −0.049, p =.026) were associated with a lower efficacy. Conclusion: Some pharmacological interventions (particularly risperidone and aripiprazole) have proved efficacy for short-term treatment of emotional dysregulation and irritability in ASD and should be considered within a multimodal treatment plan, taking into account also the tolerability profile and families’ preferences.

Original language	English
Pages (from-to)	151-168
Number of pages	18
Journal	Journal of the American Academy of Child and Adolescent Psychiatry
Volume	62
Issue number	2
Early online date	22 Apr 2022
DOIs	https://doi.org/10.1016/j.jaac.2022.03.033
Publication status	Published - Feb 2023

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Salazar de Pablo, G., Jordá, C. P., Vaquerizo-Serrano, J., Moreno, C., Cabras, A., Arango, C., Hernández, P., Veenstra-VanderWeele, J., Simonoff, E., Fusar-Poli, P., Santosh, P., Cortese, S., & Parellada, M. (2023). Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response. Journal of the American Academy of Child and Adolescent Psychiatry, 62(2), 151-168. https://doi.org/10.1016/j.jaac.2022.03.033

Salazar de Pablo, Gonzalo ; Jordá, Carolina Pastor ; Vaquerizo-Serrano, Julio et al. / Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2023 ; Vol. 62, No. 2. pp. 151-168.

@article{fe2a66d99df34f0faf39688da72e761e,

title = "Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response",

abstract = "Objective: Emotional dysregulation and irritability are common in individuals with autism spectrum disorder (ASD). We conducted the first meta-analysis assessing the efficacy of a broad range of pharmacological interventions for emotional dysregulation and irritability in ASD and predictors of response. Method: Following a preregistered protocol (PROSPERO: CRD42021235779), we systematically searched multiple databases until January 1, 2021. We included placebo-controlled randomized controlled trials (RCTs) and evaluated the efficacy of pharmacological interventions and predictors of response for emotional dysregulation and irritability. We assessed heterogeneity using Q statistics and publication bias. We conducted subanalyses and meta-regressions to identify predictors of response. The primary effect size was the standardized mean difference. Quality of studies was assessed using the Cochrane Risk of Bias Tool (RoB2). Results: A total of 2,856 individuals with ASD in 45 studies were included, among which 26.7% of RCTs had a high risk of bias. Compared to placebo, antipsychotics (standardized mean difference = 1.028, 95% CI = 0.824-1.232) and medications used to treat attention-deficit/hyperactivity disorder (ADHD) (0.471, 0.061-0.881) were significantly better than placebo in improving emotional dysregulation and irritability, whereas evidence of efficacy was not found for other drug classes (p >.05). Within individual medications, evidence of efficacy was found for aripiprazole (1.179, 0.838-1.520) and risperidone (1.074, 0.818-1.331). Increased rates of comorbid epilepsy (β = −0.049, p =.026) were associated with a lower efficacy. Conclusion: Some pharmacological interventions (particularly risperidone and aripiprazole) have proved efficacy for short-term treatment of emotional dysregulation and irritability in ASD and should be considered within a multimodal treatment plan, taking into account also the tolerability profile and families{\textquoteright} preferences.",

author = "{Salazar de Pablo}, Gonzalo and Jord{\'a}, {Carolina Pastor} and Julio Vaquerizo-Serrano and Carmen Moreno and Anna Cabras and Celso Arango and Patricia Hern{\'a}ndez and Jeremy Veenstra-VanderWeele and Emily Simonoff and Paolo Fusar-Poli and Paramala Santosh and Samuele Cortese and Mara Parellada",

note = "Funding Information: Drs. Salazar de Pablo, Vaquerizo-Serrano, and Pastor Jord{\'a} are supported by the Alicia Koplowitz Foundation . Dr. Moreno, Prof. Arango, and Dr. Parellada are supported by the Spanish Ministry of Science and Innovation , Instituto de Salud Carlos III (PI17/00819), European Regional Development Fund {\textquoteleft}A way of making Europe{\textquoteright}, financed by the European Union - NextGenerationEU (PMP21/00051), Centro de Investigaci{\'o}n Biom{\'e}dica en Red Salud Mental, Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds, European Union Seventh Framework Program, European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking: Project PRISM-2 (Grant agreement No. 101034377), Project AIMS-2-TRIALS (Grant agreement No. 777394), Horizon Europe, the National Institute of Mental Health of the National Institutes of Health under Award Number 1U01MH124639-01 (Project ProNET) and Award Number 5P50MH115846-03 (project FEP-CAUSAL), Fundaci{\'o}n Familia Alonso, and Fundaci{\'o}n Alicia Koplowitz. Prof. Fusar-Poli is supported by PSYSCAN. Prof. Simonoff is supported by the UK Medical Research Council , UK RI, EU IMI, and the NIHR Biomedical Research Centre. Prof. Santosh is supported by Reverse Rett, through Action Medical Research . Funding Information: Drs. Salazar de Pablo, Vaquerizo-Serrano, and Pastor Jord{\'a} are supported by the Alicia Koplowitz Foundation. Dr. Moreno, Prof. Arango, and Dr. Parellada are supported by the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (PI17/00819), European Regional Development Fund {\textquoteleft}A way of making Europe{\textquoteright}, financed by the European Union - NextGenerationEU (PMP21/00051), Centro de Investigaci{\'o}n Biom{\'e}dica en Red Salud Mental, Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds, European Union Seventh Framework Program, European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking: Project PRISM-2 (Grant agreement No. 101034377), Project AIMS-2-TRIALS (Grant agreement No. 777394), Horizon Europe, the National Institute of Mental Health of the National Institutes of Health under Award Number 1U01MH124639-01 (Project ProNET) and Award Number 5P50MH115846-03 (project FEP-CAUSAL), Fundaci{\'o}n Familia Alonso, and Fundaci{\'o}n Alicia Koplowitz. Prof. Fusar-Poli is supported by PSYSCAN. Prof. Simonoff is supported by the UK Medical Research Council, UK RI, EU IMI, and the NIHR Biomedical Research Centre. Prof. Santosh is supported by Reverse Rett, through Action Medical Research.Disclosure: Dr. Salazar de Pablo has received honoraria from Janssen Cilag. Dr. Moreno has been a consultant to or has received honoraria from Janssen, Angelini, Servier, Nuvelution, Otsuka, Lundbeck, and Esteve. Dr. Arango has been a consultant to or has received honoraria or grants from Acadia, Angelini, Gedeon Richter, Janssen Cilag, Lundbeck, Otsuka, Roche, Sage, Servier, Shire, Schering Plough, Sumitomo Dainippon Pharma, Sunovion, and Takeda. Dr. Veenstra-VanderWeele has served on Advisory Boards for Roche, Novartis, and SynapDx. He has received research funding from Roche, Novartis, SynapDx, Janssen, Forest, and Seaside Therapeutics. He has received editorial stipends from Wiley and Springer. Prof. Simonoff has received grant or research support from the National Institute of Health Research, the Psychiatry Research Trust, the Guy's and St. Thomas{\textquoteright} Charitable Foundation, the Economic and Social Research Council, the Medical Research Council, the National Institute of Health Research Biomedical Research Centre at South London and Maudsley Foundation Trust, and the European Commission. She has served on the advisory boards of the European ADHD Guidelines Group, Eunethydis, the Autistica Mental Health Steering Group, the National Autism Project Board, the Medical Research Council Neuroscience and Mental Health Board, the Central Institute for Mental Health, Manheim, Germany, and the Oak Foundation. She is author of the assessment tools Assessment of Consuming Behaviour (copyright, Santosh and Simonoff, manuscript in preparation) and Observation Schedule for Children with Autism (in preparation). She has served on the editorial board of the British Journal of Psychiatry. She has received honoraria from the Royal College of Physicians as Senior Clinical Advisor for the National Institute of Health and Care Excellence. Prof. Fusar-Poli has received grant support from Lundbeck and honoraria fees from Angelini, Menarini, and Lundbeck. Prof. Santosh has been a consultant to or has received honoraria or grants from Anavex Life Sciences, GW Pharma, and Newron. Professor Santosh is also the CEO and shareholder in HealthTracker Ltd. Prof. Cortese has declared reimbursement for travel and accommodation expenses from the Association for Child and Adolescent Central Health (ACAMH) in relation to lectures delivered for ACAMH, the Canadian AADHD Alliance Resource, the British Association of Psychopharmacology, and from Healthcare Convention for educational activity on ADHD. He has served as deputy editor of Evidence-Based Mental Health, associate editor of Child and Adolescent Mental Health, and on the editorial boards of the Journal of Child Psychology and Psychiatry, the Journal of Child and Adolescent Psychopharmacology, and CNS Drugs. Dr. Parellada has served as consultant or advisor or CME speaker to Servier, Exceltis, and Lundbeck. Drs. Pastor Jord{\'a}, Vaquerizo-Serrano, Cabras, and Hern{\'a}ndez have reported no biomedical financial interests or potential conflicts of interest. Publisher Copyright: {\textcopyright} 2022 American Academy of Child and Adolescent Psychiatry",

year = "2023",

month = feb,

doi = "10.1016/j.jaac.2022.03.033",

language = "English",

volume = "62",

pages = "151--168",

journal = "Journal of the American Academy of Child and Adolescent Psychiatry",

issn = "0890-8567",

publisher = "Elsevier Limited",

number = "2",

}

Salazar de Pablo, G, Jordá, CP, Vaquerizo-Serrano, J, Moreno, C, Cabras, A, Arango, C, Hernández, P, Veenstra-VanderWeele, J, Simonoff, E , Fusar-Poli, P , Santosh, P, Cortese, S & Parellada, M 2023, 'Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 62, no. 2, pp. 151-168. https://doi.org/10.1016/j.jaac.2022.03.033

Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response. / Salazar de Pablo, Gonzalo; Jordá, Carolina Pastor; Vaquerizo-Serrano, Julio et al.
In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 62, No. 2, 02.2023, p. 151-168.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response

AU - Salazar de Pablo, Gonzalo

AU - Jordá, Carolina Pastor

AU - Vaquerizo-Serrano, Julio

AU - Moreno, Carmen

AU - Cabras, Anna

AU - Arango, Celso

AU - Hernández, Patricia

AU - Veenstra-VanderWeele, Jeremy

AU - Simonoff, Emily

AU - Fusar-Poli, Paolo

AU - Santosh, Paramala

AU - Cortese, Samuele

AU - Parellada, Mara

N1 - Funding Information: Drs. Salazar de Pablo, Vaquerizo-Serrano, and Pastor Jordá are supported by the Alicia Koplowitz Foundation . Dr. Moreno, Prof. Arango, and Dr. Parellada are supported by the Spanish Ministry of Science and Innovation , Instituto de Salud Carlos III (PI17/00819), European Regional Development Fund ‘A way of making Europe’, financed by the European Union - NextGenerationEU (PMP21/00051), Centro de Investigación Biomédica en Red Salud Mental, Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds, European Union Seventh Framework Program, European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking: Project PRISM-2 (Grant agreement No. 101034377), Project AIMS-2-TRIALS (Grant agreement No. 777394), Horizon Europe, the National Institute of Mental Health of the National Institutes of Health under Award Number 1U01MH124639-01 (Project ProNET) and Award Number 5P50MH115846-03 (project FEP-CAUSAL), Fundación Familia Alonso, and Fundación Alicia Koplowitz. Prof. Fusar-Poli is supported by PSYSCAN. Prof. Simonoff is supported by the UK Medical Research Council , UK RI, EU IMI, and the NIHR Biomedical Research Centre. Prof. Santosh is supported by Reverse Rett, through Action Medical Research . Funding Information: Drs. Salazar de Pablo, Vaquerizo-Serrano, and Pastor Jordá are supported by the Alicia Koplowitz Foundation. Dr. Moreno, Prof. Arango, and Dr. Parellada are supported by the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (PI17/00819), European Regional Development Fund ‘A way of making Europe’, financed by the European Union - NextGenerationEU (PMP21/00051), Centro de Investigación Biomédica en Red Salud Mental, Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds, European Union Seventh Framework Program, European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking: Project PRISM-2 (Grant agreement No. 101034377), Project AIMS-2-TRIALS (Grant agreement No. 777394), Horizon Europe, the National Institute of Mental Health of the National Institutes of Health under Award Number 1U01MH124639-01 (Project ProNET) and Award Number 5P50MH115846-03 (project FEP-CAUSAL), Fundación Familia Alonso, and Fundación Alicia Koplowitz. Prof. Fusar-Poli is supported by PSYSCAN. Prof. Simonoff is supported by the UK Medical Research Council, UK RI, EU IMI, and the NIHR Biomedical Research Centre. Prof. Santosh is supported by Reverse Rett, through Action Medical Research.Disclosure: Dr. Salazar de Pablo has received honoraria from Janssen Cilag. Dr. Moreno has been a consultant to or has received honoraria from Janssen, Angelini, Servier, Nuvelution, Otsuka, Lundbeck, and Esteve. Dr. Arango has been a consultant to or has received honoraria or grants from Acadia, Angelini, Gedeon Richter, Janssen Cilag, Lundbeck, Otsuka, Roche, Sage, Servier, Shire, Schering Plough, Sumitomo Dainippon Pharma, Sunovion, and Takeda. Dr. Veenstra-VanderWeele has served on Advisory Boards for Roche, Novartis, and SynapDx. He has received research funding from Roche, Novartis, SynapDx, Janssen, Forest, and Seaside Therapeutics. He has received editorial stipends from Wiley and Springer. Prof. Simonoff has received grant or research support from the National Institute of Health Research, the Psychiatry Research Trust, the Guy's and St. Thomas’ Charitable Foundation, the Economic and Social Research Council, the Medical Research Council, the National Institute of Health Research Biomedical Research Centre at South London and Maudsley Foundation Trust, and the European Commission. She has served on the advisory boards of the European ADHD Guidelines Group, Eunethydis, the Autistica Mental Health Steering Group, the National Autism Project Board, the Medical Research Council Neuroscience and Mental Health Board, the Central Institute for Mental Health, Manheim, Germany, and the Oak Foundation. She is author of the assessment tools Assessment of Consuming Behaviour (copyright, Santosh and Simonoff, manuscript in preparation) and Observation Schedule for Children with Autism (in preparation). She has served on the editorial board of the British Journal of Psychiatry. She has received honoraria from the Royal College of Physicians as Senior Clinical Advisor for the National Institute of Health and Care Excellence. Prof. Fusar-Poli has received grant support from Lundbeck and honoraria fees from Angelini, Menarini, and Lundbeck. Prof. Santosh has been a consultant to or has received honoraria or grants from Anavex Life Sciences, GW Pharma, and Newron. Professor Santosh is also the CEO and shareholder in HealthTracker Ltd. Prof. Cortese has declared reimbursement for travel and accommodation expenses from the Association for Child and Adolescent Central Health (ACAMH) in relation to lectures delivered for ACAMH, the Canadian AADHD Alliance Resource, the British Association of Psychopharmacology, and from Healthcare Convention for educational activity on ADHD. He has served as deputy editor of Evidence-Based Mental Health, associate editor of Child and Adolescent Mental Health, and on the editorial boards of the Journal of Child Psychology and Psychiatry, the Journal of Child and Adolescent Psychopharmacology, and CNS Drugs. Dr. Parellada has served as consultant or advisor or CME speaker to Servier, Exceltis, and Lundbeck. Drs. Pastor Jordá, Vaquerizo-Serrano, Cabras, and Hernández have reported no biomedical financial interests or potential conflicts of interest. Publisher Copyright: © 2022 American Academy of Child and Adolescent Psychiatry

PY - 2023/2

Y1 - 2023/2

N2 - Objective: Emotional dysregulation and irritability are common in individuals with autism spectrum disorder (ASD). We conducted the first meta-analysis assessing the efficacy of a broad range of pharmacological interventions for emotional dysregulation and irritability in ASD and predictors of response. Method: Following a preregistered protocol (PROSPERO: CRD42021235779), we systematically searched multiple databases until January 1, 2021. We included placebo-controlled randomized controlled trials (RCTs) and evaluated the efficacy of pharmacological interventions and predictors of response for emotional dysregulation and irritability. We assessed heterogeneity using Q statistics and publication bias. We conducted subanalyses and meta-regressions to identify predictors of response. The primary effect size was the standardized mean difference. Quality of studies was assessed using the Cochrane Risk of Bias Tool (RoB2). Results: A total of 2,856 individuals with ASD in 45 studies were included, among which 26.7% of RCTs had a high risk of bias. Compared to placebo, antipsychotics (standardized mean difference = 1.028, 95% CI = 0.824-1.232) and medications used to treat attention-deficit/hyperactivity disorder (ADHD) (0.471, 0.061-0.881) were significantly better than placebo in improving emotional dysregulation and irritability, whereas evidence of efficacy was not found for other drug classes (p >.05). Within individual medications, evidence of efficacy was found for aripiprazole (1.179, 0.838-1.520) and risperidone (1.074, 0.818-1.331). Increased rates of comorbid epilepsy (β = −0.049, p =.026) were associated with a lower efficacy. Conclusion: Some pharmacological interventions (particularly risperidone and aripiprazole) have proved efficacy for short-term treatment of emotional dysregulation and irritability in ASD and should be considered within a multimodal treatment plan, taking into account also the tolerability profile and families’ preferences.

AB - Objective: Emotional dysregulation and irritability are common in individuals with autism spectrum disorder (ASD). We conducted the first meta-analysis assessing the efficacy of a broad range of pharmacological interventions for emotional dysregulation and irritability in ASD and predictors of response. Method: Following a preregistered protocol (PROSPERO: CRD42021235779), we systematically searched multiple databases until January 1, 2021. We included placebo-controlled randomized controlled trials (RCTs) and evaluated the efficacy of pharmacological interventions and predictors of response for emotional dysregulation and irritability. We assessed heterogeneity using Q statistics and publication bias. We conducted subanalyses and meta-regressions to identify predictors of response. The primary effect size was the standardized mean difference. Quality of studies was assessed using the Cochrane Risk of Bias Tool (RoB2). Results: A total of 2,856 individuals with ASD in 45 studies were included, among which 26.7% of RCTs had a high risk of bias. Compared to placebo, antipsychotics (standardized mean difference = 1.028, 95% CI = 0.824-1.232) and medications used to treat attention-deficit/hyperactivity disorder (ADHD) (0.471, 0.061-0.881) were significantly better than placebo in improving emotional dysregulation and irritability, whereas evidence of efficacy was not found for other drug classes (p >.05). Within individual medications, evidence of efficacy was found for aripiprazole (1.179, 0.838-1.520) and risperidone (1.074, 0.818-1.331). Increased rates of comorbid epilepsy (β = −0.049, p =.026) were associated with a lower efficacy. Conclusion: Some pharmacological interventions (particularly risperidone and aripiprazole) have proved efficacy for short-term treatment of emotional dysregulation and irritability in ASD and should be considered within a multimodal treatment plan, taking into account also the tolerability profile and families’ preferences.

UR - http://www.scopus.com/inward/record.url?scp=85134773530&partnerID=8YFLogxK

U2 - 10.1016/j.jaac.2022.03.033

DO - 10.1016/j.jaac.2022.03.033

M3 - Article

SN - 0890-8567

VL - 62

SP - 151

EP - 168

JO - Journal of the American Academy of Child and Adolescent Psychiatry

JF - Journal of the American Academy of Child and Adolescent Psychiatry

IS - 2

ER -

Salazar de Pablo G, Jordá CP, Vaquerizo-Serrano J, Moreno C, Cabras A, Arango C et al. Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response. Journal of the American Academy of Child and Adolescent Psychiatry. 2023 Feb;62(2):151-168. Epub 2022 Apr 22. doi: 10.1016/j.jaac.2022.03.033

Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response

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