MMSL 2024, 93(1):120-130 | DOI: 10.31482/mmsl.2023.013

MANAGEMENT OF AUTISM SPECTRUM DISORDER: A PILOT STUDY IN SAUDI PAEDIATRICSOriginal article

Sireen Abdul Rahim Shilbayeh ORCID...1*, Iman Sharaf Adeen ORCID...2
1 Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
2 Department of Pediatric Behavior and Development and Adolescent Medicine, King Fahad Medical City, Riyadh, Saudi Arabia

The aim of the current pilot study is to depict the pattern of management of autism spectrum disorder (ASD) in Saudi Arabia, focusing on the efficacy of risperidone in reducing the target symptoms of ASD compared to only behavioral therapy. A cross-sectional study was conducted at two main centers for 10 months. On a convenience basis, prospective visits were scheduled for children, who had received regular behavioral therapy and/or antipsychotics¬ (mainly risperidone), and their parents to assess the efficacy and side-effects of the treatment. The improvement of symptoms of ASD was assessed using the Aberrant Behavior Checklist-Community Version (ABC-CV) including five subdomains: Irritability, Lethargy, Stereotypic behavior, Hyperactivity, and Inappropriate speech. Twenty-nine children (26 boys and 3 girls) with a mean age of 8.96 years (range: 5–15 years) were included in this study. The distribution of management strategy was: risperidone (11, 37.9%), behavioral therapy only (9, 31.0%), risperidone and behavioral therapy (9, 31.0%). The use of a combination of antipsychotics and psychostimulants (17.24%) was less common than in a previous American study (38%). Surprisingly, scores for all ABC subdomains were higher than those of previous studies, indicating less efficacy of risperidone in this group. Additionally, for the Lethargy subdomain, the score was 74.3±24.3. Interestingly, children who received behavioral therapy only, had lower scores compared to their counterparts who received risperidone only in all ABC subdomains and the total score. Consistent with other reports, this study highlighted the efficacy of risperidone alongside behavioral therapy on reducing hyperactivity symptoms and total ABC score. Despite the published data regarding the efficacy and safety of risperidone, supporting that it may have an important role in the management of ASD in children, further prospective design studies in Saudi Arabia are warranted to confirm the findings or encourage its continuous employment as long-term maintenance therapy.

Keywords: Autism spectrum disorder; Risperidone; Behavioral therapy; efficacy

Received: October 2, 2022; Revised: March 22, 2023; Accepted: March 22, 2023; Prepublished online: March 29, 2023; Published: March 1, 2024  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Shilbayeh, S.A.R., & Adeen, I.S. (2024). MANAGEMENT OF AUTISM SPECTRUM DISORDER: A PILOT STUDY IN SAUDI PAEDIATRICS. MMSL, 93(1), 120-130. doi: 10.31482/mmsl.2023.013
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Howes O, Rogdaki M, Findon J, et al. Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology. 2018. Journal of Psychopharmacology (Oxford, England), 32(1):3-29. Available from: https://pubmed.ncbi.nlm.nih.gov/29237331/ Go to original source... Go to PubMed...
    2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 2018. Available from: https://ajp.psychiatryonline.org/
    3. The National Institute of Mental Health (NIMH). Attention-Deficit/Hyperactivity Disorder [Internet]. Nimh.nih.gov. 2019 [cited 10 April 2021]. Available from: https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
    4. Soke G, Maenner M, Christensen D, et al. Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010. Journal of Autism and Developmental Disorders. 2018;48(8):2663-2676. Available from: https://pubmed.ncbi.nlm.nih.gov/29524016/ Go to original source... Go to PubMed...
    5. Volkmar F, Siegel M, Woodbury-Smith M, et al. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 2014;53(2):237-257. Available from: https://www.jaacap.org/article/S0890-8567(13)00819-8/pdf Go to original source... Go to PubMed...
    6. Park H, Yi SY, Yoon SA, et al. Comparison of the Autism Diagnostic Observation Schedule and Childhood Autism Rating Scale in the Diagnosis of Autism Spectrum Disorder: A Preliminary Study. Soa--ch'ongsonyon chongsin uihak = Journal of Child & Adolescent Psychiatry. 2018;29(4):172-177. Available from: https://pubmed.ncbi.nlm.nih.gov/32595311/ Go to original source... Go to PubMed...
    7. Chlebowski C, Green J, Barton M, et al. Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of Autism and Developmental Disorders. 2010;40(7):787-799. Available from: https://pubmed.ncbi.nlm.nih.gov/20054630/ Go to original source... Go to PubMed...
    8. Sharma S, Gonda X, Tarazi F. Autism Spectrum Disorder: Classification, diagnosis and therapy. Pharmacology & Therapeutics. 2018;190:91-104. Available from: https://pubmed.ncbi.nlm.nih.gov/29763648/ Go to original source...
    9. Almandil N, Alkuroud D, AbdulAzeez S, et al. Environmental and Genetic Factors in Autism Spectrum Disorders: Special Emphasis on Data from Arabian Studies. 2019. International Journal of Environmental Research and Public Health. 2019;16(4):658. Available from: https://pubmed.ncbi.nlm.nih.gov/30813406/ Go to original source...
    10. Centers for Disease Control and Prevention [Internet]. 2020. Screening and Diagnosis of Autism Spectrum Disorder. Accessed on 3/3/2021. Available from: https://www.cdc.gov/ncbddd/autism/screening.html
    11. MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); Fragile X syndrome: Medlineplus.gov. 2020 Accessed on 3/3/2021. Available from: https://medlineplus.gov/genetics/condition/fragile-x-syndrome/
    12. Kobayashi T, Matsuyama T, Takeuchi M, et al. Autism spectrum disorder and prenatal exposure to selective serotonin reuptake inhibitors: A systematic review and meta-analysis. Reproductive Toxicology (Elmsford, N.Y.). 2016;65:170-178. Available from: https://pubmed.ncbi.nlm.nih.gov/27474253/ Go to original source... Go to PubMed...
    13. Weston L, Hodgekins J, Langdon P. Effectiveness of cognitive behavioural therapy with people who have autistic spectrum disorders: A systematic review and meta-analysis. Clinical Psychology Review. 2016;49:41-54. Available from: https://pubmed.ncbi.nlm.nih.gov/27592496/ Go to original source... Go to PubMed...
    14. Almasoud, Hanan. "The Education of children with autism in saudi arabia: A teaching guide." Special Education Department: King Saud University (2010). Available from: https://faculty.ksu.edu.sa/sites/default/files/the_education_of_children_with_autism_in_saudi.pdf
    15. Posey D, Stigler K, Erickson C, et al. Antipsychotics in the treatment of autism. The Journal of Clinical Investigation. 2008;118(1):6-14. Available from: https://pubmed.ncbi.nlm.nih.gov/18172517/ Go to original source... Go to PubMed...
    16. Spencer D, Marshall J, Post B, et al. Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders. Pediatrics. 2013;132(5):833-840. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3813388/ Go to original source... Go to PubMed...
    17. Alfageh B, Man K, Besag F, et al. Psychotropic Medication Prescribing for Neuropsychiatric Comorbidities in Individuals Diagnosed with Autism Spectrum Disorder (ASD) in the UK. Journal of Autism and Developmental Disorders. 2020;50(2):625-633. Available from: https://pubmed.ncbi.nlm.nih.gov/31724119/ Go to original source... Go to PubMed...
    18. Houghton R, Ong R, Bolognani F. Psychiatric comorbidities and use of psychotropic medications in people with autism spectrum disorder in the United States. Autism Research: Official journal of the International Society for Autism Research. 2017;10(12):2037-2047. Available from: https://pubmed.ncbi.nlm.nih.gov/28963809/ Go to original source... Go to PubMed...
    19. Frazier T, Youngstrom E, Haycook T, et al. Effectiveness of medication combined with intensive behavioral intervention for reducing aggression in youth with autism spectrum disorder. Journal of Child and Adolescent Psychopharmacology. 2010;20(3):167-177. Available from: https://pubmed.ncbi.nlm.nih.gov/20578929/ Go to original source... Go to PubMed...
    20. Blankenship K, Erickson C, Stigler K, et al. Aripiprazole for irritability associated with autistic disorder in children and adolescents aged 6-17 years. Pediatric Health. 2010;4(4):375-381. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043611/ Go to original source...
    21. Janssen Pharmaceutica. Risperdal (risperidone) package insert. Titusville, NJ; 2005.. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/020272Orig1s036,s041,020588Orig1s024,s028,s029,21444Orig1s008,s015.pdf
    22. Bristol-Myers Squibb and Otsuka America Pharmaceutical. Abilify (aripiprazole) package insert. Princeton, NJ, and Rockville, MD; 2005. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021436s038,021713s030,021729s022,021866s023lbl.pdf
    23. Dodsworth T, Kim D, Procyshyn R. A systematic review of the effects of CYP2D6 phenotypes on risperidone treatment in children and adolescents. Child and Adolescent Psychiatry and Mental Health. 2018;12:37. Available from: https://capmh.biomedcentral.com/articles/10.1186/s13034-018-0243-2 Go to original source... Go to PubMed...
    24. Aman M, Singh N, Stewart A, et al. The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency. 1985;89(5):485-491. Available from: https://pubmed.ncbi.nlm.nih.gov/3993694/ Go to PubMed...
    25. Wong A, Hsia Y, Chan E, et al. The variation of psychopharmacological prescription rates for people with autism spectrum disorder (ASD) in 30 countries. Autism Research: Official journal of the International Society for Autism Research. 2014;7(5):543-554. Available from: https://pubmed.ncbi.nlm.nih.gov/24895332/ Go to original source... Go to PubMed...
    26. Shea S, Turgay A, Carroll A, et al. Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics. 2004;114(5):e634-e641. Available from: https://pubmed.ncbi.nlm.nih.gov/15492353/ Go to original source... Go to PubMed...
    27. McCracken J, McGough J, Shah B, et al. Risperidone in children with autism and serious behavioral problems. 2002. The New England Journal of Medicine. 2002;347(5):314-321. Available from: https://pubmed.ncbi.nlm.nih.gov/12151468/ Go to original source...
    28. Pandina G, Bossie C, Youssef E, et al. Risperidone improves behavioral symptoms in children with autism in a randomized, double-blind, placebo-controlled trial. Journal of Autism and Developmental Disorders. 2007;37(2):367-373. Available from: https://pubmed.ncbi.nlm.nih.gov/17019624/ Go to original source... Go to PubMed...
    29. Troost P, Lahuis B, Steenhuis M, et al. Long-term effects of risperidone in children with autism spectrum disorders: a placebo discontinuation study. Journal of the American Academy of Child and Adolescent Psychiatry. 2005;44(11):1137-1144. Available from: https://pubmed.ncbi.nlm.nih.gov/16239862/ Go to original source... Go to PubMed...

    Return to the content