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 The leading web portal for pharmacy resources, news, education and careers November 19, 2017
Pharmacy Choice - Autism Disease State Management - November 19, 2017

Autism Disease State Management

The Pharmacist's Role In Treatment Options for Autism
by Katie Graham Lyons, Pharm.D, M.S.

Autism is a neurodevelopmental disorder with a highly variable presentation. Autism was first described in 1943 by a Leo Kanner, a Johns Hopkins University psychiatrist. Since then, the understanding, terminology and diagnostic criteria for this disease have continued to evolve. In 1980, autism was described as a separate disease state for the first time in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III). Currently, autism is one part of a spectrum of disorders recognized as Autism Spectrum Disorders (ASD) within the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR).

As more information is gained about autism, the prevalence numbers have continued to rise. Autism Spectrum Disorders are highly variable genetic disorders that are currently estimated to occur at the rate of approximately 6.6 per 1,000 children. Occurrence is higher in males than females, but the reason for this difference is unknown. There is thought that ASD is believed to be affected by environmental factors.

Once patients are identified as having ASD, treatment becomes important. Patients with ASD utilize the health care system at a higher rate than patients without ASD. Management of ASD is multi-factorial and requires chronic management with the goal of maximizing functional independence. The cornerstone of management involves behavioral therapies with medication or complementary therapies including dietary supplements which are used in an adjunctive manner.

Multiple randomized control trials have also been performed looking at supplement use for Autism. Since plasma levels of omega 3 fatty Aacids are lower in patients with Autism, a randomized placebo controlled trial was performed evaluating the effect of omega 3 fatty acids. It showed improved behavior in patients with ASD and severe behavior difficulties over placebo.

Melatonin production and release has also been shown to be altered in patients with ASD. When treatment with melatonin was evaluated in a case series, it provided benefit in sleep onset and maintenance.

A double-blind placebo controlled study evaluating Vitamin C usage showed a decrease in stereotyping behavior in patients with ASD. A separate double-blind, placebo controlled trial evaluating L-Carnosine 800mg showed improved vocabulary along with subjective improvements in the Gilliam Autism Rating Scale.

Some treatments have no evidence of benefiting patients with ASD. Dietary supplements that fall into this category include: secretin, vitamin B6/magnesium and dimethyl glycine.

Atypical antipsychotic agents are commonly prescribed in patients with ASD to help manage behavioral symptoms. Risperidone was the first drug of these agents to receive FDA approval for use in ASD. Other medication types, including anticonvulsants, antidepressants and stimulants have also been prescribed. The efficacy of these drug classes for the management of behavioral symptoms is debated.

Pharmacists need to be aware of and be able to evaluate both complementary and traditional treatment options with ASD. A pharmacist's knowledge of the medication profiles, including their risks and benefits, is helpful in providing needed information to ASD patients and caregivers.
Links - Autism
Center For Disease Control Division Developmental Disabilities The National Center for Birth Defects and Developmental Disabilities.

The Autism Society of America promotes lifelong access and opportunities for persons within the autism spectrum and their families, to be fully included, participating members of their communities through advocacy, public awareness, education, and research related to autism.

Center for the Study of Autism provides information about autism to parents and professionals, and conducts research on the efficacy of various therapeutic interventions.

Autism Research Institute is primarily devoted to conducting research, and to disseminating the results of research, on the causes of autism and on methods of preventing, diagnosing and treating autism and other severe behavioral disorders of childhood.

Autism Speakes

Autism Resources offers information and links regarding the developmental disabilities autism and Asperger's Syndrome.

If you would like to contact us please go to our Contact Page.


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