Asperger syndrome medical therapy: Difference between revisions

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{{Asperger syndrome}}
{{Asperger syndrome}}
{{CMG}}
{{CMG}} {{AE}} {{SHA}}
 
==Medical Therapy==
 
<s>No medications directly treat the core symptoms of AS.<ref name="Towbin">{{cite journal |author= Towbin KE |title= Strategies for pharmacologic treatment of high functioning autism and Asperger syndrome |journal= Child Adolesc Psychiatr Clin N Am |volume=12 |issue=1 |pages=23–45 |year=2003 |pmid=12512397 |url=http://www.childpsych.theclinics.com/article/PIIS1056499302000494/fulltext |doi=10.1016/S1056-4993(02)00049-4}}</ref> Although research into the efficacy of pharmaceutical intervention for AS is limited, it is essential to diagnose and treat [[Comorbidity|comorbid]] conditions.Deficits in self-identifying emotions or in observing effects of one's behavior on others can make it difficult for individuals with AS to see why medication may be appropriate.<ref name="Towbin" /> Medication can be effective in combination with behavioral interventions and environmental accommodations in treating comorbid symptoms such as [[anxiety]], [[clinical depression|depression]], inattention and aggression. The [[Atypical antipsychotic|atypical neuroleptic]] medications [[risperidone]] and [[olanzapine]] have been shown to reduce the associated symptoms of AS; risperidone can reduce repetitive and self-injurious behaviors, aggressive outbursts and impulsivity, and improve stereotypical patterns of behavior and social relatedness. The [[selective serotonin reuptake inhibitor]]s (SSRIs) [[fluoxetine]], [[fluvoxamine]] and [[sertraline]] have been effective in treating restricted and repetitive interests and behaviors.</s>
 
<s>Care must be taken with medications; abnormalities in [[metabolism]], [[Electrical conduction system of the heart|cardiac conduction]] times, and an increased risk of [[Diabetes mellitus type 2|type 2 diabetes]] have been raised as concerns with these medications,<ref name="Newcomer">{{cite journal |author= Newcomer JW |title= Antipsychotic medications: metabolic and cardiovascular risk |journal= J Clin Psychiatry |volume=68 |issue= suppl 4 |pages=8–13 |year=2007 |pmid=17539694}}</ref><ref name="Chavez">{{cite journal |author= Chavez B, Chavez-Brown M, Sopko MA, Rey JA |title= Atypical antipsychotics in children with pervasive developmental disorders |journal= Pediatr Drugs |volume=9 |issue=4 |pages=249–66 |year=2007 |pmid=17705564 |doi= 10.2165/00148581-200709040-00006}} </ref> along with serious long-term neurological side effects. SSRIs can lead to manifestations of behavioral activation such as increased impulsivity, aggression and sleep disturbance.  Weight gain and fatigue are commonly reported side effects of risperidone, which may also lead to increased risk for [[extrapyramidal]] symptoms such as restlessness and [[dystonia]] and increased serum [[prolactin]] levels.<ref>{{cite journal |author= Staller J |title= The effect of long-term antipsychotic treatment on prolactin |journal= J Child Adolesc Psychopharmacol |volume=16 |issue=3 |pages=317–26 |year=2006 |pmid=16768639 |doi=10.1089/cap.2006.16.317}}</ref> Sedation and weight gain are more common with olanzapine,<ref name="Chavez" /> which has also been linked with diabetes.<ref name="Newcomer" /> Sedative side-effects in school-age children<ref>{{cite journal |journal= Ann Pharmacother |year=2007 |volume=41 |issue=4 |pages=626–34 |title= Use of atypical antipsychotics in the treatment of autistic disorder |author= Stachnik JM, Nunn-Thompson C |doi=10.1345/aph.1H527 |pmid=17389666}}</ref> have ramifications for classroom learning. Individuals with AS may be unable to identify and communicate their internal moods and emotions or to tolerate side effects that for most people would not be problematic.<ref>{{cite journal |title= Asperger syndrome and high functioning autism: research concerns and emerging foci |journal= Curr Opin Psychiatry |volume=16 |issue=5 |pages=535–542 |date=2003 |author= Blacher J, Kraemer B, Schalow M |doi=10.1097/01.yco.0000087260.35258.64 |doi_brokendate= 2008-06-25}}</ref></s>
 
 


== Overview ==
== Overview ==
Medical treatments used in Asperger Syndrome include: stimulants, a-2 adrenergic agonists, atypical antipsychotics, antidepressants and anticonvulsants.<ref name="pmid25655905" /> Many studies believe that medications alone can not improve Asperger Syndrome's (AS) symptoms and other complementary interventions (social and behavioral) are required.<ref name="pmid25655905" />
Medical treatments used in Asperger Syndrome include: [[Stimulant|stimulants]], a-2 [[Adrenergic agonist|adrenergic agonists]], [[atypical antipsychotics]], [[antidepressants]] and [[Anticonvulsant|anticonvulsants]].<ref name="pmid25655905" /> Many studies believe that medications alone can not improve Asperger Syndrome's (AS) symptoms and other complementary interventions (social and behavioral) are required.<ref name="pmid25655905" />


== Medical Therapy ==
== Medical Therapy ==
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*Many studies believe that medications alone can not improve Asperger Syndrome's (AS) symptoms and other complementary interventions (social and behavioral) are required.<ref name="pmid25655905" />
*Many studies believe that medications alone can not improve Asperger Syndrome's (AS) symptoms and other complementary interventions (social and behavioral) are required.<ref name="pmid25655905" />
*Medications used in Asperger Syndrome (AS) include:<ref name="pmid25655905">{{cite journal| author=Tarazi FI, Sahli ZT, Pleskow J, Mousa SA| title=Asperger's syndrome: diagnosis, comorbidity and therapy. | journal=Expert Rev Neurother | year= 2015 | volume= 15 | issue= 3 | pages= 281-93 | pmid=25655905 | doi=10.1586/14737175.2015.1009898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25655905  }} </ref>
*Medications used in Asperger Syndrome (AS) include:<ref name="pmid25655905">{{cite journal| author=Tarazi FI, Sahli ZT, Pleskow J, Mousa SA| title=Asperger's syndrome: diagnosis, comorbidity and therapy. | journal=Expert Rev Neurother | year= 2015 | volume= 15 | issue= 3 | pages= 281-93 | pmid=25655905 | doi=10.1586/14737175.2015.1009898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25655905  }} </ref>
** Stimulants such methylphenidate and amphetamines (for comorbidity between AS and attention deficit hyperactivity disorder (ADHD))
**[[Stimulant|Stimulants]] such as [[methylphenidate]] and [[Amphetamine|amphetamines]] (for comorbidity between AS and [[Attention-deficit hyperactivity disorder|attention deficit hyperactivity disorder (ADHD)]])
** a-2 adrenergic agonists such as clonidine and guanfacine (treatment of aggression, anxiety and Tourette syndrome (TS) which are associated with AS)
** a-2 [[Adrenergic agonist|adrenergic agonists]] such as [[clonidine]] and [[guanfacine]] (treatment of aggression, [[anxiety]] and [[Tourette syndrome|Tourette syndrome (TS)]] which are associated with AS)
** Atypical antipsychotics such as aripiprazole, olanzapine, ziprasidone (treatment of aggression, hallucinations, hyperactivity, irritability, anxiety, depression in AS patients)<ref name="pmid19622537">{{cite journal| author=Crystal S, Olfson M, Huang C, Pincus H, Gerhard T| title=Broadened use of atypical antipsychotics: safety, effectiveness, and policy challenges. | journal=Health Aff (Millwood) | year= 2009 | volume= 28 | issue= 5 | pages= w770-81 | pmid=19622537 | doi=10.1377/hlthaff.28.5.w770 | pmc=2896705 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19622537  }} </ref>
**[[Atypical antipsychotics]] such as [[aripiprazole]], [[olanzapine]], [[ziprasidone]] (treatment of aggression, [[Hallucination|hallucinations]], [[hyperactivity]], [[irritability]], anxiety, [[depression]] in AS patients)<ref name="pmid19622537">{{cite journal| author=Crystal S, Olfson M, Huang C, Pincus H, Gerhard T| title=Broadened use of atypical antipsychotics: safety, effectiveness, and policy challenges. | journal=Health Aff (Millwood) | year= 2009 | volume= 28 | issue= 5 | pages= w770-81 | pmid=19622537 | doi=10.1377/hlthaff.28.5.w770 | pmc=2896705 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19622537  }} </ref>
** Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) (treatment of depressive disorders and obsessive compulsive disorder (OCD) associated with AS)
**[[Antidepressants]]<nowiki/>such as [[Selective serotonin reuptake inhibitor|selective serotonin reuptake inhibitors (SSRIs)]] (treatment of depressive disorders and [[Obsessive-compulsive disorder|obsessive compulsive disorder (OCD)]] associated with AS)
** Anticonvulsants (for aggression, mood disorders, irritability, repetitive behaviors in AS)<ref name="pmid16316486">{{cite journal| author=Hollander E, Soorya L, Wasserman S, Esposito K, Chaplin W, Anagnostou E| title=Divalproex sodium vs. placebo in the treatment of repetitive behaviours in autism spectrum disorder. | journal=Int J Neuropsychopharmacol | year= 2006 | volume= 9 | issue= 2 | pages= 209-13 | pmid=16316486 | doi=10.1017/S1461145705005791 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16316486  }} </ref>  <br />
**[[Anticonvulsant|Anticonvulsants]](for aggression, [[Mood disorder|mood disorders]], irritability, repetitive behaviors in AS)<ref name="pmid16316486">{{cite journal| author=Hollander E, Soorya L, Wasserman S, Esposito K, Chaplin W, Anagnostou E| title=Divalproex sodium vs. placebo in the treatment of repetitive behaviours in autism spectrum disorder. | journal=Int J Neuropsychopharmacol | year= 2006 | volume= 9 | issue= 2 | pages= 209-13 | pmid=16316486 | doi=10.1017/S1461145705005791 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16316486  }} </ref>  <br />


==References==
==References==

Latest revision as of 14:27, 22 June 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

Overview

Medical treatments used in Asperger Syndrome include: stimulants, a-2 adrenergic agonists, atypical antipsychotics, antidepressants and anticonvulsants.[1] Many studies believe that medications alone can not improve Asperger Syndrome's (AS) symptoms and other complementary interventions (social and behavioral) are required.[1]

Medical Therapy

References

  1. 1.0 1.1 1.2 1.3 Tarazi FI, Sahli ZT, Pleskow J, Mousa SA (2015). "Asperger's syndrome: diagnosis, comorbidity and therapy". Expert Rev Neurother. 15 (3): 281–93. doi:10.1586/14737175.2015.1009898. PMID 25655905.
  2. Crystal S, Olfson M, Huang C, Pincus H, Gerhard T (2009). "Broadened use of atypical antipsychotics: safety, effectiveness, and policy challenges". Health Aff (Millwood). 28 (5): w770–81. doi:10.1377/hlthaff.28.5.w770. PMC 2896705. PMID 19622537.
  3. Hollander E, Soorya L, Wasserman S, Esposito K, Chaplin W, Anagnostou E (2006). "Divalproex sodium vs. placebo in the treatment of repetitive behaviours in autism spectrum disorder". Int J Neuropsychopharmacol. 9 (2): 209–13. doi:10.1017/S1461145705005791. PMID 16316486.


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