TY - JOUR
T1 - Rating of the effectiveness of 26 psychiatric and seizure medications for autism spectrum disorder
T2 - Results of a national survey
AU - Coleman, Devon M.
AU - Adams, James
AU - Anderson, Amy L.
AU - Frye, Richard E.
N1 - Funding Information:
J.B.A. has several patent applications related to microbiota transplant therapy for ASD, and is a consultant for and has received research grants from Finch Therapeutics and Crestovo (now part of Finch Therapeutics), companies that produce purified microbiota for microbiota transplant therapy. He is also the President of the Autism Nutrition Research Center, a nonprofit that produces a vitamin/mineral supplement based on his research, but he serves as a volunteer and does not receive any salary or royalties from them. R.E.F. is a consultant for and has received research support from Finch Therapeutics, and is funded for a clinical trial by Zynerba Pharmaceuticals, Inc. D.M.C. and A.L.A. have no institutional or corporate/commercial relationships to disclose.
Publisher Copyright:
© Devon M. Coleman et al. 2019; Published by Mary Ann Liebert, Inc. 2019.
PY - 2019/3
Y1 - 2019/3
N2 - Objective: The objective of this study was to provide an evaluation of the benefits and adverse effects (AEs) of psychiatric and seizure medications commonly used for individuals with autism spectrum disorder (ASD). Methods: As part of the National Survey on Treatment Effectiveness for Autism, we report ratings of 26 psychiatric and seizure medications by 505 participants. Each medication was rated with a standardized scale for overall benefits, overall AEs, and specific symptoms affected. The frequency of use and net perceived benefit (overall benefit minus overall AE) are reported. Results: Most medications were rated as having a slightly greater benefit than AE. Six medications (lamotrigine, oxcarbazepine, clonidine, guanfacine, buspirone, and sertraline) had benefit ratings that were more than twice their adverse rating. Conversely, some medications had slightly negative net benefit ratings (worse AEs than benefits on average), including Adderall, Paroxetine, Quetiapine, Olanzapine, and Topiramate. However, there were wide variations in individual ratings of benefit and AEs, suggesting that clinical response to medications was highly variable, so these scores simply represent averages. A ranking of the top medications (those with the highest net perceived benefit) for each of 18 different symptoms is provided, which may provide some clinical guidance as to which medications may be most worth considering for a given symptom. A comparison of the survey results with the results of clinical trials shows generally good agreement in terms of medication benefits with some differences; in some cases the differences are because the clinical trials did not assess all of the symptoms assessed by this survey. Conclusions: It is hoped that physicians and their patients will find the survey results useful in selecting the most promising medications for a given symptom, and also for monitoring for likely benefits and AEs, especially for medications for which few or no studies have been carried out in ASD populations.
AB - Objective: The objective of this study was to provide an evaluation of the benefits and adverse effects (AEs) of psychiatric and seizure medications commonly used for individuals with autism spectrum disorder (ASD). Methods: As part of the National Survey on Treatment Effectiveness for Autism, we report ratings of 26 psychiatric and seizure medications by 505 participants. Each medication was rated with a standardized scale for overall benefits, overall AEs, and specific symptoms affected. The frequency of use and net perceived benefit (overall benefit minus overall AE) are reported. Results: Most medications were rated as having a slightly greater benefit than AE. Six medications (lamotrigine, oxcarbazepine, clonidine, guanfacine, buspirone, and sertraline) had benefit ratings that were more than twice their adverse rating. Conversely, some medications had slightly negative net benefit ratings (worse AEs than benefits on average), including Adderall, Paroxetine, Quetiapine, Olanzapine, and Topiramate. However, there were wide variations in individual ratings of benefit and AEs, suggesting that clinical response to medications was highly variable, so these scores simply represent averages. A ranking of the top medications (those with the highest net perceived benefit) for each of 18 different symptoms is provided, which may provide some clinical guidance as to which medications may be most worth considering for a given symptom. A comparison of the survey results with the results of clinical trials shows generally good agreement in terms of medication benefits with some differences; in some cases the differences are because the clinical trials did not assess all of the symptoms assessed by this survey. Conclusions: It is hoped that physicians and their patients will find the survey results useful in selecting the most promising medications for a given symptom, and also for monitoring for likely benefits and AEs, especially for medications for which few or no studies have been carried out in ASD populations.
KW - autism spectrum disorders
KW - medications
KW - online survey
KW - psychiatric medications
KW - seizure medications
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U2 - 10.1089/cap.2018.0121
DO - 10.1089/cap.2018.0121
M3 - Article
C2 - 30724573
AN - SCOPUS:85062631304
SN - 1044-5463
VL - 29
SP - 107
EP - 123
JO - Journal of Child and Adolescent Psychopharmacology
JF - Journal of Child and Adolescent Psychopharmacology
IS - 2
ER -