Review

.2018 Jan;32(1):3-29.

doi: 10.1177/0269881117741766. Epub 2017 Dec 14.

Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology

Oliver D Howes^{1 2}, Maria Rogdaki¹, James L Findon³, Robert H Wichers³, Tony Charman⁴, Bryan H King⁵, Eva Loth³, Gráinne M McAlonan^{6 7}, James T McCracken⁸, Jeremy R Parr⁹, Carol Povey¹⁰, Paramala Santosh¹¹, Simon Wallace¹², Emily Simonoff¹³, Declan G Murphy^{6 7}

Affiliations

¹ 1 MRC London Institute of Medical Sciences, London, UK.
² 2 Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
³ 3 Sackler Institute for Translational Neurodevelopment, King's College London, London, UK.
⁴ 4 Department of Psychology, King's College London, London UK.
⁵ 5 Department of Psychiatry, University of California at San Francisco, San Francisco, USA.
⁶ 6 The Sackler Centre and Forensic and Neurodevelopmental Science Behavioural and Developmental Psychiatry, Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK.
⁷ 7 NIHR-BRC for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK.
⁸ 8 Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, USA.
⁹ 9 Institute of Neuroscience, Newcastle University, Newcastle, UK.
¹⁰ 10 The National Autistic Society, London, UK.
¹¹ 11 Department of Child Psychiatry, King's College London, London, UK.
¹² 12 AT-Autism, London, UK.
¹³ 13 Department of Child and Adolescent Psychiatry, King's College London, London, UK.

PMID:29237331
PMCID: PMC5805024
DOI: 10.1177/0269881117741766

Review

Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology

Oliver D Howes et al. J Psychopharmacol.2018 Jan.

.2018 Jan;32(1):3-29.

doi: 10.1177/0269881117741766. Epub 2017 Dec 14.

Authors

Affiliations

¹ 1 MRC London Institute of Medical Sciences, London, UK.
² 2 Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
³ 3 Sackler Institute for Translational Neurodevelopment, King's College London, London, UK.
⁴ 4 Department of Psychology, King's College London, London UK.
⁵ 5 Department of Psychiatry, University of California at San Francisco, San Francisco, USA.
⁶ 6 The Sackler Centre and Forensic and Neurodevelopmental Science Behavioural and Developmental Psychiatry, Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK.
⁷ 7 NIHR-BRC for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK.
⁸ 8 Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, USA.
⁹ 9 Institute of Neuroscience, Newcastle University, Newcastle, UK.
¹⁰ 10 The National Autistic Society, London, UK.
¹¹ 11 Department of Child Psychiatry, King's College London, London, UK.
¹² 12 AT-Autism, London, UK.
¹³ 13 Department of Child and Adolescent Psychiatry, King's College London, London, UK.

PMID:29237331
PMCID: PMC5805024
DOI: 10.1177/0269881117741766

Abstract

An expert review of the aetiology, assessment, and treatment of autism spectrum disorder, and recommendations for diagnosis, management and service provision was coordinated by the British Association for Psychopharmacology, and evidence graded. The aetiology of autism spectrum disorder involves genetic and environmental contributions, and implicates a number of brain systems, in particular the gamma-aminobutyric acid, serotonergic and glutamatergic systems. The presentation of autism spectrum disorder varies widely and co-occurring health problems (in particular epilepsy, sleep disorders, anxiety, depression, attention deficit/hyperactivity disorder and irritability) are common. We did not recommend the routine use of any pharmacological treatment for the core symptoms of autism spectrum disorder. In children, melatonin may be useful to treat sleep problems, dopamine blockers for irritability, and methylphenidate, atomoxetine and guanfacine for attention deficit/hyperactivity disorder. The evidence for use of medication in adults is limited and recommendations are largely based on extrapolations from studies in children and patients without autism spectrum disorder. We discuss the conditions for considering and evaluating a trial of medication treatment, when non-pharmacological interventions should be considered, and make recommendations on service delivery. Finally, we identify key gaps and limitations in the current evidence base and make recommendations for future research and the design of clinical trials.

Keywords: Autism; aetiology; guidelines; neurodevelopmental; treatment.

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Conflict of interest statement

Oliver D Howes

Conflicts of Interest: Dr Howes has received investigator-initiated research funding from and/or participated in advisory/ speaker meetings organised by Astra-Zeneca, Autifony, BMS, Eli Lilly, Heptares, Jansenn, Lundbeck, Lyden-Delta, Otsuka, Servier, Sunovion, Rand and Roche.

Maria Rogdaki

Conflicts of Interest: None

James L. Findon

Conflicts of Interest: None

Robert H. Wichers

Conflicts of Interest: None

Tony Charman

Conflicts of Interest: None

Bryan H. King

Conflicts of Interest: None

Eva Loth

Conflicts of Interest: None

Note: I'm not a member of the BAP – see title?

Gráinne M. McAlonan

Conflicts of Interest: None

James T. McCracken

Conflicts of Interest: Alcobra Pharmaceuticals (DSMB honorarium), Psyadon Pharmaceuticals (clinical trial), AstraZeneca (study medication)

Jeremy R Parr

Conflicts of Interest: None

Paramala Santosh

Conflicts of Interest: Newron Pharmaceuticals (clinical trial).

Simon Wallace

Conflicts of Interest: None

Declan G. Murphy

Conflicts of Interest: None

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Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology

Affiliations

Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology

Authors

Affiliations

Abstract

Conflict of interest statement

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Related information

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LinkOut - more resources

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Medical