Atomoxetine for attention deficit hyperactivity disorder in children and adolescents with autism: A systematic review and meta-analysis / Suravi PATRA in Autism Research, 12-4 (April 2019)  

Public ISBD [article]  inAutism Research > 12-4 (April 2019) . - p.542-552 Titre : Atomoxetine for attention deficit hyperactivity disorder in children and adolescents with autism: A systematic review and meta-analysis Type de document : texte imprimé Auteurs : Suravi PATRA, Auteur ; Naresh NEBHINANI, Auteur ; Anisha VISWANATHAN, Auteur ; Richard KIRUBAKARAN, Auteur Article en page(s) : p.542-552 Langues : Anglais (eng) Mots-clés : atomoxetine  attention deficit/hyperactivity disorder  autism  meta-analysis  pervasive developmental disorder Index. décimale : PER Périodiques Résumé : Atomoxetine is prescribed to children with autism spectrum disorder having symptoms of attention deficit hyperactivity disorder. We sought to examine the efficacy and safety of atomoxetine in this population. After screening for inclusion criteria, we identified three randomized placebo controlled trials involving 241 children. We assessed internal validity using standard Cochrane Risk of bias tool for randomized controlled trials (RCTs). We used Revman 5.3 for meta-analysis and GRADE approach to create summary of findings with grading of the quality of evidence. Atomoxetine had a benefit on improving parent-rated hyperactivity (standardized mean difference [SMD] = -0.73, 95% Confidence Interval, CI = -1.15 to -0.34) and parent-rated inattention (SMD = -0.53, 95% CI = -0.93 to -0.12) but the magnitude of effects is uncertain. However, atomoxetine was also associated with increased risk of non-serious adverse effects like nausea and vomiting, decreased sleep, and decreased appetite. Atomoxetine may be effective in improving hyperactivity and inattention in children with autism spectrum disorder and attention deficit hyperactivity disorder. However, we are uncertain about the true effect of this intervention and need more RCTs trials designed to evaluate this. Autism Research 2019, 12: 542-552. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Atomoxetine is prescribed for Attention Deficit Hyperactivity Disorder (ADHD). About a third of children and adolescents with autism also suffer from ADHD. We carried out an analysis of data reported from a specific kind of medication trials which had examined the effectiveness and side effects of atomoxetine in this patient population. We could find only three such trials and analyzed the reported data. Our analysis revealed that atomoxetine is effective in improving symptoms of ADHD like hyperactivity and inattention and also causes side effects like nausea, vomiting, decreased sleep, and decreased appetite. However, the existing data are insufficient to provide a conclusive statement with certainty and more trials are needed for this. En ligne : https://dx.doi.org/10.1002/aur.2059 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=388 [article] Atomoxetine for attention deficit hyperactivity disorder in children and adolescents with autism: A systematic review and meta-analysis [texte imprimé] / Suravi PATRA, Auteur ; Naresh NEBHINANI, Auteur ; Anisha VISWANATHAN, Auteur ; Richard KIRUBAKARAN, Auteur . - p.542-552. Langues : Anglais (eng) in Autism Research > 12-4 (April 2019) . - p.542-552 Mots-clés : atomoxetine  attention deficit/hyperactivity disorder  autism  meta-analysis  pervasive developmental disorder Index. décimale : PER Périodiques Résumé : Atomoxetine is prescribed to children with autism spectrum disorder having symptoms of attention deficit hyperactivity disorder. We sought to examine the efficacy and safety of atomoxetine in this population. After screening for inclusion criteria, we identified three randomized placebo controlled trials involving 241 children. We assessed internal validity using standard Cochrane Risk of bias tool for randomized controlled trials (RCTs). We used Revman 5.3 for meta-analysis and GRADE approach to create summary of findings with grading of the quality of evidence. Atomoxetine had a benefit on improving parent-rated hyperactivity (standardized mean difference [SMD] = -0.73, 95% Confidence Interval, CI = -1.15 to -0.34) and parent-rated inattention (SMD = -0.53, 95% CI = -0.93 to -0.12) but the magnitude of effects is uncertain. However, atomoxetine was also associated with increased risk of non-serious adverse effects like nausea and vomiting, decreased sleep, and decreased appetite. Atomoxetine may be effective in improving hyperactivity and inattention in children with autism spectrum disorder and attention deficit hyperactivity disorder. However, we are uncertain about the true effect of this intervention and need more RCTs trials designed to evaluate this. Autism Research 2019, 12: 542-552. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Atomoxetine is prescribed for Attention Deficit Hyperactivity Disorder (ADHD). About a third of children and adolescents with autism also suffer from ADHD. We carried out an analysis of data reported from a specific kind of medication trials which had examined the effectiveness and side effects of atomoxetine in this patient population. We could find only three such trials and analyzed the reported data. Our analysis revealed that atomoxetine is effective in improving symptoms of ADHD like hyperactivity and inattention and also causes side effects like nausea, vomiting, decreased sleep, and decreased appetite. However, the existing data are insufficient to provide a conclusive statement with certainty and more trials are needed for this. En ligne : https://dx.doi.org/10.1002/aur.2059 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=388

Consensus or chaos: Survey of prescribing practices of New Zealand child and adolescent psychiatrists for children and adolescents with autism spectrum disorder / Hiran THABREW in Research in Autism Spectrum Disorders, 74 (June 2020)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 74 (June 2020) . - p.101553 Titre : Consensus or chaos: Survey of prescribing practices of New Zealand child and adolescent psychiatrists for children and adolescents with autism spectrum disorder Type de document : texte imprimé Auteurs : Hiran THABREW, Auteur ; Anisha VISWANATHAN, Auteur ; Matthew J.F. EGGLESTON, Auteur ; Stephanie MOOR, Auteur ; David CHINN, Auteur Article en page(s) : p.101553 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Autism  Children  Adolescents  Pharmacotherapy  Guidelines Index. décimale : PER Périodiques Résumé : Background There is limited national and international guidance on appropriate prescription of medications for children and adolescents with Autism Spectrum Disorder (ASD). In order to develop more detailed guidelines for prescribing for New Zealand children and young people with ASD, it is important to have some understanding of the nature of current prescribing and the circumstances that drive pharmacotherapy for children and young people with ASD. Method Seventy child and adolescent psychiatrists in New Zealand were electronically surveyed. Participants were asked to outline the four most common medications that they prescribed to address both core symptoms and comorbidities in children and young people with ASD. Additional questions included commonly used doses and durations of use, perceived effectiveness, adverse effects, level of confidence in prescribing and preferences for receiving up to date guidance about pharmacotherapy. Results Prescription by child and adolescent psychiatrists was most commonly undertaken for anxiety, sleep disturbance, ADHD, depression and restricted and repetitive behaviours (RRBs). The greatest difference in opinion regarding the value of medication related to the treatment of RRBs. The most commonly prescribed medications were fluoxetine, methylphenidate, melatonin, risperidone, quetiapine and clonidine. A range of non-pharmacological therapies were also described. Conclusions Although there appears to be general agreement between New Zealand child and adolescent psychiatrists regarding prescribing for children and young people with ASD, current clinical practice is not adequately informed by existing guidelines. Better dissemination of national guidelines incorporating both contemporary international evidence regarding medication efficacy and locally developed algorithms based on clinician consensus would be useful. En ligne : https://doi.org/10.1016/j.rasd.2020.101553 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422 [article] Consensus or chaos: Survey of prescribing practices of New Zealand child and adolescent psychiatrists for children and adolescents with autism spectrum disorder [texte imprimé] / Hiran THABREW, Auteur ; Anisha VISWANATHAN, Auteur ; Matthew J.F. EGGLESTON, Auteur ; Stephanie MOOR, Auteur ; David CHINN, Auteur . - p.101553. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 74 (June 2020) . - p.101553 Mots-clés : Autism spectrum disorder  Autism  Children  Adolescents  Pharmacotherapy  Guidelines Index. décimale : PER Périodiques Résumé : Background There is limited national and international guidance on appropriate prescription of medications for children and adolescents with Autism Spectrum Disorder (ASD). In order to develop more detailed guidelines for prescribing for New Zealand children and young people with ASD, it is important to have some understanding of the nature of current prescribing and the circumstances that drive pharmacotherapy for children and young people with ASD. Method Seventy child and adolescent psychiatrists in New Zealand were electronically surveyed. Participants were asked to outline the four most common medications that they prescribed to address both core symptoms and comorbidities in children and young people with ASD. Additional questions included commonly used doses and durations of use, perceived effectiveness, adverse effects, level of confidence in prescribing and preferences for receiving up to date guidance about pharmacotherapy. Results Prescription by child and adolescent psychiatrists was most commonly undertaken for anxiety, sleep disturbance, ADHD, depression and restricted and repetitive behaviours (RRBs). The greatest difference in opinion regarding the value of medication related to the treatment of RRBs. The most commonly prescribed medications were fluoxetine, methylphenidate, melatonin, risperidone, quetiapine and clonidine. A range of non-pharmacological therapies were also described. Conclusions Although there appears to be general agreement between New Zealand child and adolescent psychiatrists regarding prescribing for children and young people with ASD, current clinical practice is not adequately informed by existing guidelines. Better dissemination of national guidelines incorporating both contemporary international evidence regarding medication efficacy and locally developed algorithms based on clinician consensus would be useful. En ligne : https://doi.org/10.1016/j.rasd.2020.101553 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422

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