[Autism and attention deficit hyperactivity disorder: pharmacological intervention]

Rev Neurol. 2013 Sep 6;57 Suppl 1:S205-10.
[Article in Spanish]

Abstract

The cardinal symptoms of attention deficit hyperactivity disorder (ADHD)--inattention, hyperactivity and impulsiveness--are not specific and may be found in the general population and in other disorders. These symptoms are present in over 50% of patients with autism spectrum disorders (ASD). It thus seems quite clear that both problems can coexist in these patients. The usual pharmacological treatments for ADHD, methylphenidate and atomoxetine, appear to be useful in reducing the above-mentioned symptoms in patients with ADHD and ASD. Effectiveness seems to be lower in patients with ASD and tolerance is slightly poorer. This may be conditioned by a number of variables, including: the complexity of ASD, association with mental retardation, polypharmacotherapy, and so on. Given the long-term tolerance profile of methylphenidate and atomoxetine, these treatments appear to be a good alternative with which to improve the problems of attention and self-control these patients have. Nevertheless, further controlled studies are needed to confirm this proposition.

Title: Autismo y trastorno por deficit de atencion/hiperactividad: intervencion farmacologica.

Los sintomas cardinales del trastorno por deficit de atencion/hiperactividad (TDAH), la inatencion, la hiperactividad y la impulsividad, no son especificos y pueden encontrarse en la poblacion general y en otros trastornos. Estos sintomas se encuentran presentes en mas del 50% de los pacientes con trastornos del espectro autista (TEA). Parece clara, por tanto, la coexistencia de ambos problemas en estos pacientes. Los tratamientos farmacologicos habituales para el TDAH, el metilfenidato y la atomoxetina, parecen ser utiles en la reduccion de los sintomas senalados en pacientes con TDAH y TEA. La eficacia en los pacientes con TEA parece ser inferior, y la tolerancia, levemente peor. Esto puede estar condicionado por numerosas variables: complejidad del TEA, asociacion con el retraso mental, polifarmacoterapia... Dado el perfil de tolerancia a largo plazo del metilfenidato y la atomoxetina, estos tratamientos se muestran como una buena alternativa para la mejora de los problemas atencionales y autocontrol de estos pacientes; sin embargo, son necesarios mas estudios controlados para afirmar esta propuesta.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adrenergic Uptake Inhibitors / therapeutic use
  • Atomoxetine Hydrochloride
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / pathology
  • Brain / drug effects
  • Brain / pathology
  • Central Nervous System Stimulants / therapeutic use
  • Child
  • Child Development Disorders, Pervasive / drug therapy*
  • Child Development Disorders, Pervasive / pathology
  • Clonidine / therapeutic use
  • Dopamine Uptake Inhibitors / therapeutic use
  • Drug Evaluation
  • Guanfacine / therapeutic use
  • Humans
  • Methylphenidate / therapeutic use
  • Neuroimaging
  • Propylamines / therapeutic use
  • Psychotropic Drugs / therapeutic use
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Adrenergic Uptake Inhibitors
  • Central Nervous System Stimulants
  • Dopamine Uptake Inhibitors
  • Propylamines
  • Psychotropic Drugs
  • Methylphenidate
  • Guanfacine
  • Atomoxetine Hydrochloride
  • Clonidine