ADHD Medication May Be Effective in Treatment of Hyperactivity in Autism

Main Category: Autism
Article Date: 06 Nov 2005 - 6:00 PDT

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Children with autism may benefit from a drug commonly prescribed for attention-deficit hyperactivity disorder (ADHD), according to research published in the November issue of the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION ARCHIVES OF GENERAL PSYCHIATRY.

In the largest study yet of a stimulant medication for autism, researchers at five centers associated with the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network enrolled 72 children in a placebo-controlled study. The researchers were studying the effect of methylphenidate, better known by the brand name Ritalin, on hyperactive children with autism and other autism spectrum disorders associated with impairment of social interaction and functioning.

"This was an important study because to date there is no FDA-approved medication for autism spectrum disorders," said the study's corresponding author David J. Posey, M.D., associate professor of psychiatry and chief of the Christian Sarkine Autism Treatment Center at the Indiana University School of Medicine.

Researchers were interested in whether methylphenidate would be effective in reducing hyperactivity and impulsiveness in children with autism spectrum disorders. Each child participated in a one-week phase to test tolerance of three different dose levels of the medication.

That portion of the trial was followed by a four-week phase during which children were given one of the three doses of methylphenidate previously tested or a placebo. Children who had a positive response were treated for an additional eight weeks to ensure their response was stable.

There were no serious adverse effects, but 14 children withdrew from the study due to intolerable side effects. Of the 58 others completing the study, 35 responded well to methylphenidate and experienced a significant reduction in hyperactivity. However, the reduction in symptoms for the entire group of 58 was not as great as is typically seen when this medication is used to treat children with ADHD.

Additional analyses are underway to determine if there are any genetic predictors of response or tolerability, said Dr. Posey.

"This study shows that methylphenidate is a treatment option for children with autism spectrum disorder and hyperactivity," said Dr. Posey. A therapeutic trial of methylphenidate may be indicated for children with autism and hyperactivity since some of these children may benefit and any adverse effects would be brief provided that both parents and practitioners are prepared to suspend treatment when significant side effects occur, he explained.

The study was funded by the National Institute of Mental Health. Other sites in the RUPP Autism Network involved in this study are Ohio State University (principal investigators Michael Aman and L. Eugene Arnold), UCLA (principal investigator James McCracken), Yale University (principal investigator Lawrence Scahill) and Johns Hopkins University (principal investigator Elaine Tierney). Christopher McDougle, M.D., professor and chair of the IU Department of Psychiatry, was the principal investigator for the IU study.

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