New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 4: Treatment and management of ASD
Recommendations:
4.4.10 There is insufficient evidence to make any recommendation with respect to the
use of the following drugs for ASD-specific symptoms in children with ASD.
However, these medications are in current use, and may be used by experienced
clinicians, who maintain up to date knowledge of the literature:
Grade
I
• clonidine
• sedatives (benzodiazepines, antihistamines).
4.4.11 There is insufficient evidence to make any recommendation with respect to the
use of the following drugs for ASD-specific symptoms in children with ASD.
The opinion of the Guideline Development Team is that these medications are
unlikely to be useful:
I
• amantadine
• intravenous immunoglobulins
• naltrexone.
4.4.12 The use of the following drugs and agents is NOT recommended:
• fenfluramine
• secretin
• chelation therapy.
4.4.13 Clinicians prescribing more than one medication or prescribing any additional
medication must consider the possibility of drug interactions.
A
A
C
C
Children and young people
The mainstays of treatment for behavioural, emotional and mental health problems are supportive,
educational and behavioural approaches. No medication has been identified as a cure for ASD.
However, a number of medications may be helpful in significantly improving various target
symptoms and associated conditions. Many of these same medications can continue to be used in
adults with ASD but there is little evidence to provide specific comparative advice on effectiveness
and safety.
The use of alternative strategies for behavioural difficulties, including behavioural and psychological
approaches, environmental modification to ensure safety of the child and others, and adequate
provision of respite care, should always be considered before using pharmacotherapy. However, it is
also acknowledged that many behavioural procedures are also of unknown efficacy and safety. These
approaches can be time consuming, expensive and stressful for the child and/or the child’s family
and whänau.
Part 4
There are very few well-controlled studies of medications in ASD, particularly in children and
adolescents. However, some evidence is accumulating for treatment of both aspects of core autistic
symptomatology (largely compulsive and repetitive patterns – the ‘cluster c’ symptomatology
of DSM IV) and frequent co-morbid symptoms, including anxiety and aggression. Of necessity,
New Zealand Autism Spectrum Disorder Guideline 145