ABSTRACT
OBJECTIVE: The authors assessed the effects of D-cycloserine on the core symptom of social impairment in subjects with autism. METHOD: Following a 2-week, single-blind placebo lead-in phase, drug-free subjects with autistic disorder were administered three different doses of D-cycloserine during each of three 2-week periods. Measures used for subject ratings included the Clinical Global Impression (CGI) scale and Aberrant Behavior Checklist. RESULTS: Significant improvement was found on the CGI and social withdrawal subscale of the Aberrant Behavior Checklist. d-Cycloserine was well tolerated at most of the doses used in this study. CONCLUSIONS: In this pilot study, D-cycloserine treatment resulted in significant improvement in social withdrawal. Further controlled studies of D-cycloserine in autism appear warranted.
Subject(s)
Autistic Disorder/drug therapy , Cycloserine/therapeutic use , Social Behavior Disorders/drug therapy , Adolescent , Adult , Autistic Disorder/psychology , Child , Child, Preschool , Cycloserine/administration & dosage , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Male , Pilot Projects , Placebos , Prospective Studies , Social Behavior Disorders/psychology , Treatment OutcomeABSTRACT
OBJECTIVE: The aim of this study was to retrospectively review a large sample of children and adolescents with pervasive developmental disorders (PDDs) treated with open-label guanfacine in order to gather preliminary data as to its effectiveness and safety. METHOD: Eighty (80) subjects with PDDs (10 females, 70 males) (mean +/- SD age = 7.7 +/- 3.5 years, range 3-18 years) were treated with guanfacine within an academic specialty clinic. Charts were reviewed to determine the response of specific target symptoms, including hyperactivity, inattention, and impulsivity. The relationship between treatment response and age, diagnosis, level of cognitive impairment, and symptom severity was determined. Adverse effects were also evaluated. RESULTS: Guanfacine (mean daily dose = 2.6 +/- 1.7 mg, range 0.25-9 mg; mean duration of treatment = 334 +/- 374 days, range 7-1776 days) treatment was effective in 19 of 80 (23.8%) subjects. Subjects with PDD not otherwise specified (11 of 28 responders; 39.3%) and Asperger's disorder (2 of 6 responders; 33.3%) showed a greater rate of global response than those with autistic disorder (6 of 46 responders; 13.0 %). There was a trend for subjects without comorbid mental retardation (9 of 24 subjects; 37.5%) to respond at a greater rate than those with mental retardation (10 of 56 subjects; 17.9%). Symptom improvement was seen in hyperactivity, inattention, insomnia, and tics. Guanfacine was well tolerated, and did not lead to significant changes in blood pressure or heart rate. CONCLUSIONS: Guanfacine may have a role in the treatment of hyperactivity and inattention occurring in some persons with PDDs. Further studies are needed to determine its efficacy in this population.
Subject(s)
Adrenergic alpha-Agonists/therapeutic use , Attention Deficit Disorder with Hyperactivity/drug therapy , Attention Deficit Disorder with Hyperactivity/psychology , Child Development Disorders, Pervasive/drug therapy , Child Development Disorders, Pervasive/psychology , Guanfacine/therapeutic use , Adolescent , Adrenergic alpha-Agonists/adverse effects , Aging/psychology , Asperger Syndrome/drug therapy , Asperger Syndrome/psychology , Child , Child, Preschool , Cognition Disorders/drug therapy , Cognition Disorders/etiology , Cognition Disorders/psychology , Electrocardiography/drug effects , Female , Guanfacine/adverse effects , Hemodynamics/drug effects , Humans , Impulsive Behavior/drug therapy , Impulsive Behavior/psychology , Intellectual Disability/complications , Intellectual Disability/psychology , Male , Psychiatric Status Rating Scales , Retrospective StudiesABSTRACT
OBJECTIVE: To conduct a preliminary evaluation of the safety and effectiveness of ziprasidone in children, adolescents, and young adults with autism. METHOD: Twelve patients (mean age +/- SD, 11.62 +/- 4.38 years; range, 8-20 years) with DSM-IV-defined autism (n = 9) or pervasive developmental disorder not otherwise specified (n = 3) received open-label treatment with ziprasidone (mean daily dose, 59.23 +/- 34.76 mg; range, 20-120 mg) for at least 6 weeks (mean duration, 14.15 +/- 8.29 weeks; range, 6-30 weeks). RESULTS: Six (50%) of the 12 patients were considered responders based on a Clinical Global Impression Scale rating of "much improved" or "very much improved." Transient sedation was the most common side effect. No cardiovascular side effects, including chest pain, tachycardia, palpitations, dizziness, or syncope, were observed or reported. The mean change in body weight for the group was -5.83 +/- 12.52 lb (range, -35 to +6 lb). Five patients lost weight, five had no change, one gained weight, and one had no follow-up weight obtained beyond the baseline measurement. CONCLUSIONS: Ziprasidone appears to have the potential for improving symptoms of aggression, agitation, and irritability in children, adolescents, and young adults with autism. Significant weight gain was not observed in this short-term trial. Double-blind, placebo-controlled studies are needed to substantiate these preliminary findings.
