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Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study.
Autism. 2015 Jan; 19(1):102-6.A

Abstract

Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p < 0.0001), diagnosis of autistic disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain.

Authors+Show Affiliations

Seattle Children's Hospital, USA.Cincinnati Children's Hospital Medical Center, USA.Riley Children's Hospital, USA Indiana University School of Medicine, USA.Riley Children's Hospital, USA Indiana University School of Medicine, USA.Riley Children's Hospital, USA Indiana University School of Medicine, USA.Lurie Center for Autism, USA.Cincinnati Children's Hospital Medical Center, USA Craig.Erickson@cchmc.org.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24571823

Citation

Adler, Benjamin A., et al. "Drug-refractory Aggression, Self-injurious Behavior, and Severe Tantrums in Autism Spectrum Disorders: a Chart Review Study." Autism : the International Journal of Research and Practice, vol. 19, no. 1, 2015, pp. 102-6.
Adler BA, Wink LK, Early M, et al. Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study. Autism. 2015;19(1):102-6.
Adler, B. A., Wink, L. K., Early, M., Shaffer, R., Minshawi, N., McDougle, C. J., & Erickson, C. A. (2015). Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study. Autism : the International Journal of Research and Practice, 19(1), 102-6. https://doi.org/10.1177/1362361314524641
Adler BA, et al. Drug-refractory Aggression, Self-injurious Behavior, and Severe Tantrums in Autism Spectrum Disorders: a Chart Review Study. Autism. 2015;19(1):102-6. PubMed PMID: 24571823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study. AU - Adler,Benjamin A, AU - Wink,Logan K, AU - Early,Maureen, AU - Shaffer,Rebecca, AU - Minshawi,Noha, AU - McDougle,Christopher J, AU - Erickson,Craig A, Y1 - 2014/02/26/ PY - 2014/2/28/entrez PY - 2014/2/28/pubmed PY - 2015/8/27/medline KW - aggression KW - atypical antipsychotics KW - autism KW - autism spectrum disorders KW - self-injurious behavior KW - severe tantrums SP - 102 EP - 6 JF - Autism : the international journal of research and practice JO - Autism VL - 19 IS - 1 N2 - Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p < 0.0001), diagnosis of autistic disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain. SN - 1461-7005 UR - https://www.unboundmedicine.com/medline/citation/24571823/Drug_refractory_aggression_self_injurious_behavior_and_severe_tantrums_in_autism_spectrum_disorders:_a_chart_review_study_ L2 - http://journals.sagepub.com/doi/full/10.1177/1362361314524641?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -