Pharmacotherapy in Autism Spectrum Disorder: How, When and Why

Abstract

Psychiatric comorbidities are more frequent in ASD population if compared to neurotypical development peers. Several studies reported that nearly three-quarters of children and adolescents with ASD also have another psychiatric condition that contributes to worsen their clinical condition and has a negative impact on the quality of life of the entire family. The treatment of ASD symptoms and comorbidities is based on a multimodal approach of behavioural, educational and pharmacological treatments. Pharmacotherapy is employed when other therapies are unable to control the symptoms and are often useful to increase the patient’s compliance with other psychoeducational treatments. About 50% - 60% of children with ASD undergo drug therapy to reduce behaviour problems and comorbidities, and polypharmacy is common in about 30%-40%. The use of drug therapy increases with age and antipsychotics, psychostimulants and antidepressants are among the most widely used drugs. Despite the high frequency of psychotropic medication in this population, there is scarce evidence in the literature, supported by studies often limited by a low sample size, a heterogeneous population and without a control group. Large RCT on more commonly prescribed psychotropic drugs in ASD children are needed for a better evaluation of risks and benefits in ASD pediatric patients.