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Examining the Use of Oral Aripiprazole in Patients With Autism Spectrum Disorder: A Study of Retrospective Chart Review at a University Medical Center

  • Jae Hyun Han (Department of Psychiatry, Seoul National University Bundang Hospital) ;
  • Jong Myeong Kim (Department of Psychiatry, Seoul National University Bundang Hospital) ;
  • Hee Jeong Yoo (Department of Psychiatry, Seoul National University Bundang Hospital)
  • Received : 2023.09.21
  • Accepted : 2024.01.02
  • Published : 2024.04.01

Abstract

Objectives: The purpose of this study was to examine the patterns of use of oral aripiprazole treatment in children and adolescents diagnosed with autism spectrum disorder (ASD) at a university medical center in Korea. Methods: We retrospectively reviewed the medical records of 164 outpatient children and adolescents diagnosed with ASD by child and adolescent psychiatrists. Patient demographic characteristics, clinical features, age and dose of aripiprazole treatment, associated adverse events, and concomitant medications, etc. were evaluated. Results: Aripiprazole treatment was initiated at a mean age of 7.64 years, at a mean initial dose of 1.15 mg. Methylphenidate was often co-administered with aripiprazole. The most commonly reported adverse effects were increased appetite and weight gain, which in some cases led to discontinuation of medication. Conclusion: A follow-up study is warranted to evaluate the efficacy and safety of aripiprazole treatment in Korean children and adolescents diagnosed with ASD, and it is crucial to consider their clinical characteristics and response to treatment in the evaluation.

Keywords

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM-5-TR®). Washington, DC: American Psychiatric Association;2022. 
  2. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry 2008;47:921-929.  https://doi.org/10.1097/CHI.0b013e318179964f
  3. Yildiz M, Demir Y, Kircali A, Incedere A. Caregiver burden in schizophrenia and autism spectrum disorders: a comparative study. Psychiatry Investig 2021;18:1180-1187.  https://doi.org/10.30773/pi.2021.0165
  4. Breaux R, Baweja R, Eadeh HM, Shroff DM, Cash AR, Swanson CS, et al. Systematic review and meta-analysis: pharmacological and nonpharmacological interventions for persistent nonepisodic irritability. J Am Acad Child Adolesc Psychiatry 2023;62:318-334.  https://doi.org/10.1016/j.jaac.2022.05.012
  5. Posey DJ, Stigler KA, Erickson CA, McDougle CJ. Antipsychotics in the treatment of autism. J Clin Invest 2008;118:6-14.  https://doi.org/10.1172/JCI32483
  6. Remington G, Sloman L, Konstantareas M, Parker K, Gow R. Clomipramine versus haloperidol in the treatment of autistic disorder: a double-blind, placebo-controlled, crossover study. J Clin Psychopharmacol 2001;21:440-444.  https://doi.org/10.1097/00004714-200108000-00012
  7. Doyle CA, McDougle CJ. Pharmacologic treatments for the behavioral symptoms associated with autism spectrum disorders across the lifespan. Dialogues Clin Neurosci 2012;14:263-279.  https://doi.org/10.31887/DCNS.2012.14.3/cdoyle
  8. Mano-Sousa BJ, Pedrosa AM, Alves BC, Galduroz JCF, Belo VS, Chaves VE, et al. Effects of risperidone in autistic children and young adults: a systematic review and meta-analysis. Curr Neuropharmacol 2021;19:538-552.  https://doi.org/10.2174/1570159X18666200529151741
  9. Ghanizadeh A, Tordjman S, Jaafari N. Aripiprazole for treating irritability in children & adolescents with autism: a systematic review. Indian J Med Res 2015;142:269-275.  https://doi.org/10.4103/0971-5916.166584
  10. Hirsch LE, Pringsheim T. Aripiprazole for autism spectrum disorders (ASD). Cochrane Database Syst Rev 2016;2016:CD009043. 
  11. Ito H, Takano H, Arakawa R, Takahashi H, Kodaka F, Takahata K, et al. Effects of dopamine D2 receptor partial agonist antipsychotic aripiprazole on dopamine synthesis in human brain measured by PET with L-[β-11C]DOPA. PLoS One 2012;7:e46488. 
  12. Sullivan LC, Clarke WP, Berg KA. Atypical antipsychotics and inverse agonism at 5-HT2 receptors. Curr Pharm Des 2015;21:3732-3738.  https://doi.org/10.2174/1381612821666150605111236
  13. Marcus RN, Owen R, Kamen L, Manos G, McQuade RD, Carson WH, et al. A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. J Am Acad Child Adolesc Psychiatry 2009;48:1110-1119.  https://doi.org/10.1097/CHI.0b013e3181b76658
  14. Owen R, Sikich L, Marcus RN, Corey-Lisle P, Manos G, McQuade RD, et al. Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. Pediatrics 2009;124:1533-1540.  https://doi.org/10.1542/peds.2008-3782
  15. Blankenship K, Erickson CA, Stigler KA, Posey DJ, McDougle CJ. Aripiprazole for irritability associated with autistic disorder in children and adolescents aged 6-17 years. Ped Health 2010;4:375-381.  https://doi.org/10.2217/phe.10.45
  16. Teff KL, Rickels MR, Grudziak J, Fuller C, Nguyen HL, Rickels K. Antipsychotic-induced insulin resistance and postprandial hormonal dysregulation independent of weight gain or psychiatric disease. Diabetes 2013;62:3232-3240.  https://doi.org/10.2337/db13-0430
  17. Blonde L, Kan HJ, Gutterman EM, L'Italien GJ, Kim MS, Hanssens L, et al. Predicted risk of diabetes and coronary heart disease in patients with schizophrenia: aripiprazole versus standard of care. J Clin Psychiatry 2008;69:741-748. https://doi.org/10.4088/JCP.v69n0507