Atypical Antipsychotics for Irritability in Pediatric Autism: A Systematic Review and Network Meta-Analysis
| Autor: | Mateen Shaikh, Teresa Bennett, Binod Neupane, Daniel Rusiecki, Joseph Beyene, Merrick S Fallah |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
genetic structures
Autism Spectrum Disorder Network Meta-Analysis Behavioral therapy Aripiprazole Irritability behavioral disciplines and activities 03 medical and health sciences 0302 clinical medicine mental disorders medicine Humans Pharmacology (medical) Child Randomized Controlled Trials as Topic business.industry food and beverages Risperidone medicine.disease Child development Irritable Mood Checklist 030227 psychiatry Psychiatry and Mental health Autism spectrum disorder Meta-analysis Pediatrics Perinatology and Child Health Autism medicine.symptom business 030217 neurology & neurosurgery Antipsychotic Agents Clinical psychology |
| Zdroj: | Journal of Child and Adolescent Psychopharmacology. 29:168-180 |
| ISSN: | 1557-8992 1044-5463 |
| DOI: | 10.1089/cap.2018.0115 |
| Popis: | Irritability is common in pediatric autism spectrum disorder (ASD) patients. This can have major implications in child development, receptivity to behavioral therapy, as well as child and caregiver well-being. A systematic review and network meta-analysis were conducted to assess the efficacy and safety of atypical antipsychotics in treating irritability in these patients.Studies were identified from Medline, Embase, and PsycINFO from inception to March 2018. The clinical trials database was reviewed. Studies were included if they were a double-blind, randomized controlled trial utilizing the Aberrant Behavior Checklist Irritability (ABC-I) to measure the efficacy of atypical antipsychotic monotherapy. Data extraction was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses for network meta-analysis guidelines. The main outcome was the reduction in irritability score using the ABC-I subscale from baseline.Eight trials comparing four interventions-risperidone, aripiprazole, lurasidone, and placebo in 878 patients, were included. Both risperidone and aripiprazole had significantly reduced ABC-I scores than placebo. Estimates of mean differences (95% credible intervals) were risperidone, -6.89 (-11.14, -2.54); aripiprazole, -6.62 (-10.88, -2.22); and lurasidone, -1.61 (-9.50, 6.23). Both risperidone and aripiprazole had similar safety. There were only eight studies included in the analysis, however, sample sizes were not small. Variance in reporting of adverse effects limited the quality of safety analysis.Risperidone and aripiprazole were the two best drugs, with comparable efficacy and safety in pediatric ASD patients. These two medications could be beneficial in improving irritability in these patients. |
| Databáze: | OpenAIRE |
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