Pharmacotherapy of restricted/repetitive behavior in autism spectrum disorder:a systematic review and meta-analysis
Open Access
- 12 March 2020
- journal article
- review article
- Published by Springer Science and Business Media LLC in BMC Psychiatry
- Vol. 20 (1), 1-11
- https://doi.org/10.1186/s12888-020-2477-9
Abstract
This paper is a systematic review and meta-analysis of the efficacy of available medications for the treatment of restricted/repetitive behavior (RRBs) in Autism Spectrum Disorder (ASD). We searched MEDLINE, Embase, PsycINFO, The Cochrane Library (Cochrane Database of Systematic Reviews (CDRS), the Cochrane Central Register of Controlled Trials (CENTRAL), database of Abstracts of Reviews of Effects (DARE)), Scopus, Epistimonikos, Clinicaltrials.gov, and included all randomized controlled trials published after 1993 that were directed at RRBs in patients with ASD of all ages. We extracted the relevant data from the published studies with a predefined data extraction form and assessed the risk of bias. The primary outcomes were change in restricted/repetitive behavior. We performed a meta-analysis using the random effect model and included studies with given mean and standard deviation. This study is registered with PROSPERO number CRD42018092660). We identified 14 randomized controlled trials that met initial inclusion criteria. After closer inspection, nine trials – involving 552 patients in total – were included in the final analysis. The meta-analysis found no significant difference between medications (including fluvoxamine, risperidone, fluoxetine, citalopram, oxytocin, N-Acetylcysteine, buspirone) and placebo in the treatment of RRBs in ASD (P = 0.20). Similarly, the sub-group meta-analysis also showed no significant difference between Selective Serotonin Reuptake Inhibitor (SSRIs) and placebo in the treatment of RRBs in ASD (P = 0.68). There was no evidence of publication bias. This meta-analysis finds little support for the routine use of medications to treat restricted/repetitive behaviors in Autism Spectrum Disorder. Further research of large, balanced trials with precise assessment tools and long-term follow-up are needed. The study protocol is registered in PROSPERO (Reference number: CRD42018092660).Keywords
Funding Information
- TRoNA (N/A)
This publication has 46 references indexed in Scilit:
- Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysisMolecular Autism, 2013
- Subcategories of Restricted and Repetitive Behaviors in Children with Autism Spectrum DisordersJournal of Autism and Developmental Disorders, 2012
- Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication BiasPEDIATRICS, 2012
- Intranasal oxytocin versus placebo in the treatment of adults with autism spectrum disorders: a randomized controlled trialMolecular Autism, 2012
- Aripiprazole for the treatment of irritability associated with autismExpert Opinion on Pharmacotherapy, 2011
- Emerging drugs for the treatment of symptoms associated with autism spectrum disordersEmerging Drugs, 2010
- Autism spectrum and obsessive–compulsive disorders: OC behaviors, phenotypes and geneticsAutism Research, 2009
- Reevaluating the incidence of pervasive developmental disorders: Impact of elevated rates of detection through implementation of an integrated system of screening in Toyota, JapanPsychiatry and Clinical Neurosciences, 2008
- PsycINFO search strategies identified methodologically sound therapy studies and review articles for use by clinicians and researchersJournal of Clinical Epidemiology, 2008
- A Placebo Controlled Crossover Trial of Liquid Fluoxetine on Repetitive Behaviors in Childhood and Adolescent AutismNeuropsychopharmacology, 2004