Aripiprazole for Irritability Associated with Autistic Disorder in Children and Adolescents Aged 6–17 Years

Kelly Blankenship; Craig A Erickson; Kimberly A Stigler; David J Posey; Christopher J McDougle

Disclosures

Pediatr Health. 2010;4(4):375-381. 

In This Article

Conclusion

Autistic disorder and other PDDs are lifelong illnesses that can cause multiple symptoms that may interfere with many facets of functioning. Among other symptoms, individuals with PDDs may exhibit irritability that can take the form of aggression, self-injurious behavior or severe tantrums. Left untreated, these can become dangerous for the individuals and their caregivers.[2] Until recently, risperidone was the only FDA-approved medication to treat these symptoms. Aripiprazole has recently received approval to treat these behaviors in individuals with autistic disorder aged 6–17 years. In clinical practice, aripiprazole has been effective in decreasing irritability and aggression in those older than 17 years. However, dosing guidelines for those older than 17 years have not been approved by the FDA.

Studies of aripiprazole have provided information regarding the side-effect profile, clinical efficacy and safety in the PDD population. The studies that have been performed demonstrate aripiprazole's efficacy in treating irritability associated with PDDs. Owing to the potential side effects, the American Psychiatric Association and the American Diabetes Association recommended that those prescribing aripiprazole (and all atypical antipsychotics) monitor vital signs, fasting lipids and fasting glucose at baseline, 3 months after treatment onset and then annually. Weight should be assessed prior to treatment, at 4, 8 and 12 weeks and then quarterly.[22] As in any individual receiving an antipsychotic, monitoring for abnormal movements is also recommended.[104] Results pertaining to longer-term safety and tolerability studies of aripiprazole in children and adolescents with autism will be important to consider once they are published.

For optimal results when treating an individual with PDD, behavioral therapy interventions should be considered.

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