Therapies for Children With Autism Spectrum Disorders

Table 33. Summary of results of medical studies (continued)
Intervention Study design/Quality Study results and overall strength of evidence
Stimulants and other medications to treat hyperactivity
Stimulants
1 RCT / 1 good 228-230
2 Retrospective case
series 231,233
109
• Improvement in hyperactivity and non-compliance
in one study.
• Adverse events, including increases in challenging
behavior and loss of appetite.
• Strength of evidence for effectiveness in affecting
hyperactivity is insufficient.
• Strength of evidence around adverse events is
also insufficient.
Guanfacine 1 Retrospective case series 232 • Symptom improvement observed for hyperactivity,
inattention, insomnia, and tics.
• Strength of evidence for effectiveness on
hyperactivity and inattention is insufficient.
Secretin vs. placebo
Dietary interventions and
supplements
Various medical
Interventions
Secretin
7 RCTs / 2 good, 237,238 5 fair 234-
236,239,240
1 Prospective case series 241
1 RCT/ 1 fair 249
4 Prospective case
series 242,243,245,246
Dietary interventions
Other interventions
9 RCTs / 2 good, 64,254 6
fair, 247,248,251-253,257 1 poor 250,255
1 Prospective case series 256
1 Retrospective case series 244
• No studies showed significantly greater
improvements in the secretin group;
• No difference for porcine or synthetic secretin.
• Strength of evidence is high for lack of
effectiveness in affecting language, cognition,
behavior, communication, autism symptom
severity, and socialization.
• Some studies showed improvements with iron
supplementation, magnesium and vitamins, fish
oil, evening primrose oil and ketogenic diet.
• Some lessening of food selectivity behaviors in
study of dietary enzyme supplementation.
• Few studies had comparison groups and most
were poor.
• Insufficient evidence to determine effectiveness.
• Early promise for omega 3 fatty acids, melatonin,
L-carnosine, and piracetam.
• 85% of parents reported decrease in or resolution
of sleep problems with melatonin; problems
returned in some children.
• One good RCT of hyperbaric oxygen showed
benefit on general ratings and social and
challenging behaviors.
• Fair RCT of pentoxifylline added to risperidone
compared with risperidone+ placebo showed
significant improvements in irritability,
lethargy/social withdrawal, stereotypic behavior,
hyperactivity, and inappropriate speech for the
pentoxifylline group.
• No effect for cholinesterase inhibitors (donepezil)
on language or behavior.
• Amantadine, oral immunoglobulin, and the
chelating agent DMSA showed no benefit in single
RCTs.
• Insufficient evidence to determine strength of the
evidence for any one of the various medical
interventions.
• Insufficient evidence in any one category.
DMSA=dimercaptosuccinic acid; RCT=randomized controlled trial; SRI=serotonin reuptake inhibitor