Title:Potential Benefits and Limits of Psychopharmacological Therapies in Pervasive Developmental Disorders
Volume: 9
Issue: 4
Author(s): Massimo Molteni, Maria Nobile, Dario Cattaneo, Sonia Radice and Emilio Clementi
Affiliation:
Keywords:
Autism spectrum disorders, pharmacology, pharmacogenetics, pharmacovigilance, therapeutic drug monitoring.
Abstract: The core symptoms of Autistic Spectrum Disorder (ASD) are impairment in reciprocal social interaction,
communication, narrow interests, and stereotyped behaviour. These are frequently severe and persistent, although their
severity may change over the course of life. Furthermore, the frequently associated symptoms of self-injury, aggressive
behaviour, impulsivity, poor attention, anxiety, depression, and sleep disruption, can become a major source of additional
distress and interference in functioning.
The causes of autism are not yet known, but there is a general consensus that ASDs are highly heritable. Comprehension
of the neurobiological basis for autism-spectrum disorders is still in its initial stages: a large body of research, however,
has established ASD signs and symptoms are of neurological origin, and suggest that autism is a distributed neural system
disorder, which disproportionately impairs many higher order abilities. Currently available medical treatments, primarily
address co-morbid symptoms, rather than core symptoms. Thus, in spite of recent advances in psychopharmacology, the
treatment approach still has important limits and shows poor efficacy on global outcomes.
A potential pathway for improving clinical outcomes is that of the personalised treatment for autism, by using therapeutic
drug monitoring (TDM) - a valuable tool for drugs with narrow therapeutic index - as well as systematic genetic
background assessment, foreseen in future applications. However, it is already possible to implement an active
surveillance programme to address safety concerns and to optimise therapeutic drug interventions in ASD.
