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Aripiprazole in autism spectrum disorder: current evidence for use

Part of: BJPsych Advances Cochrane Corner and Round the Corner Collection

Published online by Cambridge University Press:  26 April 2023

Apphia Bunting Open the ORCID record for Apphia Bunting [Opens in a new window]  and
Harriet Feldman Open the ORCID record for Harriet Feldman [Opens in a new window]
Apphia Bunting
Affiliation:
Specialty trainee in psychiatry with Oxford Health NHS Foundation Trust, Oxford, UK. She has an interest in deprescribing in psychiatry.
Harriet Feldman*
Affiliation:
Specialty trainee in psychiatry with Oxford Health NHS Foundation Trust and an Academic Clinical Fellow in the Department of Psychiatry, University of Oxford, UK. She is interested in immune dysfunction in psychosis.
*
Correspondence Dr Harriet Feldman. Email: harriet.feldman@psych.ox.ac.uk
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Summary

This month's Cochrane Corner meta-analysis evaluates the evidence for the use of aripiprazole in ‘autism spectrum disorders’ – although in fact, outcome measures mainly included subtypes of challenging behaviour and side-effects. Aripiprazole was found to be effective in reducing irritability and hyperactivity, while causing extrapyramidal side-effects and weight gain. Only three trials were included in the review, with two small trials eventually included in the meta-analysis. All trials were conducted in under-18s in the USA, with no requirement for a trial of behavioural management before psychotropic medication, and excluding under-18s with important comorbidities such as medicated attention-deficit hyperactivity disorder. All three studies were sponsored and funded by the manufacturer of aripiprazole. Further, a discontinuation trial showed no evidence of sustained benefit beyond 16 weeks of treatment.

Keywords

Antipsychoticsautism spectrum disordersrandomised controlled trialstatistical methodologyCochrane Review
Type
Round the corner
Information
BJPsych Advances , Volume 29 , Special Issue 5: Neurodevelopmental disorders including intellectual disability: a Clinical Toolkit for Mental Health Professionals (Part 2) , September 2023 , pp. 290 - 294
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

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Footnotes

Commentary on… Aripiprazole for autism spectrum disorders (ASD) (Cochrane Corner). See this issue at https://doi.org/10.1192/bja.2023.15.

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