Impact of comorbid autism spectrum disorders on stimulant response in children with attention deficit hyperactivity disorder: a retrospective and prospective effectiveness study. Santosh, P J, Baird, G, Pityaratstian, N, Tavare, E, & Gringras, P Child Care Health Dev., 32(5):575--583, September, 2006. Paper doi abstract bibtex BACKGROUND: In the recent past, psychiatrists and paediatricians have avoided prescribing stimulant medication, such as methylphenidate and dexamphetamine to patients with autism spectrum disorders (ASD) because of both doubts about efficacy and concern that these medications make stereotypies worse. Recently, a number of small trials have suggested that methyphenidate does have a role in the management of hyperactivity in children with autistic spectrum disorders. METHODS: Children with ASD and attention deficit hyperactivity disorder (ADHD), and children with ADHD without ASD received standard treatment with methyphenidate from one specialist centre. A combination of standardized and novel outcome tools was used to allow both an exploratory retrospective study of 174 children and then a prospective study of a further 52 children to be carried out. RESULTS: After treatment with stimulants, the subjects in both groups showed statistically significant improvements in target symptoms of 'hyperactivity', 'impulsivity', 'inattention', 'oppositionality', 'aggression' and 'intermittent explosive rage'. The Clinical Global Impression-Improvement and efficacy index measures also improved in each group. In both the retrospective and the prospective studies, there was no statistically significant difference in the degree of improvements between each group. Importantly, neither tics nor repetitive behaviours worsened in either group. Children in the 'ADHD-only' group who were prescribed stimulants experienced significant 'nausea', 'giddiness', 'headaches' and 'sleep difficulties', whereas sleep difficulties were the only side effect that emerged in children in the ASD with ADHD group. CONCLUSIONS: Both studies presented here support previous findings from smaller studies that show children with autism and ADHD can respond as well to stimulants as children with ADHD alone. Although randomized controlled trials remain the gold standard for efficacy studies, systems like this that allow clinicians to continue rigorous and consistent monitoring for many years have a valuable role to play. Furthermore, such monitoring systems which now exist electronically can easily accumulate large data sets and reveal details about long-term effectiveness and long-term side effects of medication that are unlikely to be discovered in short-term trials.
@article{santosh_impact_2006,
title = {Impact of comorbid autism spectrum disorders on stimulant response in children with attention deficit hyperactivity disorder: a retrospective and prospective effectiveness study},
volume = {32},
issn = {0305-1862},
url = {http://dx.doi.org/10.1111/j.1365-2214.2006.00631.x},
doi = {10.1111/j.1365-2214.2006.00631.x},
abstract = {BACKGROUND: In the recent past, psychiatrists and paediatricians have
avoided prescribing stimulant medication, such as methylphenidate and
dexamphetamine to patients with autism spectrum disorders (ASD) because of
both doubts about efficacy and concern that these medications make
stereotypies worse. Recently, a number of small trials have suggested that
methyphenidate does have a role in the management of hyperactivity in
children with autistic spectrum disorders. METHODS: Children with ASD and
attention deficit hyperactivity disorder (ADHD), and children with ADHD
without ASD received standard treatment with methyphenidate from one
specialist centre. A combination of standardized and novel outcome tools
was used to allow both an exploratory retrospective study of 174 children
and then a prospective study of a further 52 children to be carried out.
RESULTS: After treatment with stimulants, the subjects in both groups
showed statistically significant improvements in target symptoms of
'hyperactivity', 'impulsivity', 'inattention', 'oppositionality',
'aggression' and 'intermittent explosive rage'. The Clinical Global
Impression-Improvement and efficacy index measures also improved in each
group. In both the retrospective and the prospective studies, there was no
statistically significant difference in the degree of improvements between
each group. Importantly, neither tics nor repetitive behaviours worsened
in either group. Children in the 'ADHD-only' group who were prescribed
stimulants experienced significant 'nausea', 'giddiness', 'headaches' and
'sleep difficulties', whereas sleep difficulties were the only side effect
that emerged in children in the ASD with ADHD group. CONCLUSIONS: Both
studies presented here support previous findings from smaller studies that
show children with autism and ADHD can respond as well to stimulants as
children with ADHD alone. Although randomized controlled trials remain the
gold standard for efficacy studies, systems like this that allow
clinicians to continue rigorous and consistent monitoring for many years
have a valuable role to play. Furthermore, such monitoring systems which
now exist electronically can easily accumulate large data sets and reveal
details about long-term effectiveness and long-term side effects of
medication that are unlikely to be discovered in short-term trials.},
number = {5},
journal = {Child Care Health Dev.},
author = {Santosh, P J and Baird, G and Pityaratstian, N and Tavare, E and Gringras, P},
month = sep,
year = {2006},
keywords = {Sep 20 import, duplicate},
pages = {575--583}
}
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{"_id":"LQtpeuWT5B2mbvKYm","bibbaseid":"santosh-baird-pityaratstian-tavare-gringras-impactofcomorbidautismspectrumdisordersonstimulantresponseinchildrenwithattentiondeficithyperactivitydisorderaretrospectiveandprospectiveeffectivenessstudy-2006","downloads":0,"creationDate":"2018-04-27T04:04:45.352Z","title":"Impact of comorbid autism spectrum disorders on stimulant response in children with attention deficit hyperactivity disorder: a retrospective and prospective effectiveness study","author_short":["Santosh, P J","Baird, G","Pityaratstian, N","Tavare, E","Gringras, P"],"year":2006,"bibtype":"article","biburl":"https://bibbase.org/zotero/davidlloyd33","bibdata":{"bibtype":"article","type":"article","title":"Impact of comorbid autism spectrum disorders on stimulant response in children with attention deficit hyperactivity disorder: a retrospective and prospective effectiveness study","volume":"32","issn":"0305-1862","url":"http://dx.doi.org/10.1111/j.1365-2214.2006.00631.x","doi":"10.1111/j.1365-2214.2006.00631.x","abstract":"BACKGROUND: In the recent past, psychiatrists and paediatricians have avoided prescribing stimulant medication, such as methylphenidate and dexamphetamine to patients with autism spectrum disorders (ASD) because of both doubts about efficacy and concern that these medications make stereotypies worse. Recently, a number of small trials have suggested that methyphenidate does have a role in the management of hyperactivity in children with autistic spectrum disorders. METHODS: Children with ASD and attention deficit hyperactivity disorder (ADHD), and children with ADHD without ASD received standard treatment with methyphenidate from one specialist centre. A combination of standardized and novel outcome tools was used to allow both an exploratory retrospective study of 174 children and then a prospective study of a further 52 children to be carried out. RESULTS: After treatment with stimulants, the subjects in both groups showed statistically significant improvements in target symptoms of 'hyperactivity', 'impulsivity', 'inattention', 'oppositionality', 'aggression' and 'intermittent explosive rage'. The Clinical Global Impression-Improvement and efficacy index measures also improved in each group. In both the retrospective and the prospective studies, there was no statistically significant difference in the degree of improvements between each group. Importantly, neither tics nor repetitive behaviours worsened in either group. Children in the 'ADHD-only' group who were prescribed stimulants experienced significant 'nausea', 'giddiness', 'headaches' and 'sleep difficulties', whereas sleep difficulties were the only side effect that emerged in children in the ASD with ADHD group. CONCLUSIONS: Both studies presented here support previous findings from smaller studies that show children with autism and ADHD can respond as well to stimulants as children with ADHD alone. Although randomized controlled trials remain the gold standard for efficacy studies, systems like this that allow clinicians to continue rigorous and consistent monitoring for many years have a valuable role to play. Furthermore, such monitoring systems which now exist electronically can easily accumulate large data sets and reveal details about long-term effectiveness and long-term side effects of medication that are unlikely to be discovered in short-term trials.","number":"5","journal":"Child Care Health Dev.","author":[{"propositions":[],"lastnames":["Santosh"],"firstnames":["P","J"],"suffixes":[]},{"propositions":[],"lastnames":["Baird"],"firstnames":["G"],"suffixes":[]},{"propositions":[],"lastnames":["Pityaratstian"],"firstnames":["N"],"suffixes":[]},{"propositions":[],"lastnames":["Tavare"],"firstnames":["E"],"suffixes":[]},{"propositions":[],"lastnames":["Gringras"],"firstnames":["P"],"suffixes":[]}],"month":"September","year":"2006","keywords":"Sep 20 import, duplicate","pages":"575--583","bibtex":"@article{santosh_impact_2006,\n\ttitle = {Impact of comorbid autism spectrum disorders on stimulant response in children with attention deficit hyperactivity disorder: a retrospective and prospective effectiveness study},\n\tvolume = {32},\n\tissn = {0305-1862},\n\turl = {http://dx.doi.org/10.1111/j.1365-2214.2006.00631.x},\n\tdoi = {10.1111/j.1365-2214.2006.00631.x},\n\tabstract = {BACKGROUND: In the recent past, psychiatrists and paediatricians have\navoided prescribing stimulant medication, such as methylphenidate and\ndexamphetamine to patients with autism spectrum disorders (ASD) because of\nboth doubts about efficacy and concern that these medications make\nstereotypies worse. Recently, a number of small trials have suggested that\nmethyphenidate does have a role in the management of hyperactivity in\nchildren with autistic spectrum disorders. METHODS: Children with ASD and\nattention deficit hyperactivity disorder (ADHD), and children with ADHD\nwithout ASD received standard treatment with methyphenidate from one\nspecialist centre. A combination of standardized and novel outcome tools\nwas used to allow both an exploratory retrospective study of 174 children\nand then a prospective study of a further 52 children to be carried out.\nRESULTS: After treatment with stimulants, the subjects in both groups\nshowed statistically significant improvements in target symptoms of\n'hyperactivity', 'impulsivity', 'inattention', 'oppositionality',\n'aggression' and 'intermittent explosive rage'. The Clinical Global\nImpression-Improvement and efficacy index measures also improved in each\ngroup. In both the retrospective and the prospective studies, there was no\nstatistically significant difference in the degree of improvements between\neach group. Importantly, neither tics nor repetitive behaviours worsened\nin either group. Children in the 'ADHD-only' group who were prescribed\nstimulants experienced significant 'nausea', 'giddiness', 'headaches' and\n'sleep difficulties', whereas sleep difficulties were the only side effect\nthat emerged in children in the ASD with ADHD group. CONCLUSIONS: Both\nstudies presented here support previous findings from smaller studies that\nshow children with autism and ADHD can respond as well to stimulants as\nchildren with ADHD alone. Although randomized controlled trials remain the\ngold standard for efficacy studies, systems like this that allow\nclinicians to continue rigorous and consistent monitoring for many years\nhave a valuable role to play. Furthermore, such monitoring systems which\nnow exist electronically can easily accumulate large data sets and reveal\ndetails about long-term effectiveness and long-term side effects of\nmedication that are unlikely to be discovered in short-term trials.},\n\tnumber = {5},\n\tjournal = {Child Care Health Dev.},\n\tauthor = {Santosh, P J and Baird, G and Pityaratstian, N and Tavare, E and Gringras, P},\n\tmonth = sep,\n\tyear = {2006},\n\tkeywords = {Sep 20 import, duplicate},\n\tpages = {575--583}\n}\n\n","author_short":["Santosh, P J","Baird, G","Pityaratstian, N","Tavare, E","Gringras, P"],"key":"santosh_impact_2006","id":"santosh_impact_2006","bibbaseid":"santosh-baird-pityaratstian-tavare-gringras-impactofcomorbidautismspectrumdisordersonstimulantresponseinchildrenwithattentiondeficithyperactivitydisorderaretrospectiveandprospectiveeffectivenessstudy-2006","role":"author","urls":{"Paper":"http://dx.doi.org/10.1111/j.1365-2214.2006.00631.x"},"keyword":["Sep 20 import","duplicate"],"downloads":0},"search_terms":["impact","comorbid","autism","spectrum","disorders","stimulant","response","children","attention","deficit","hyperactivity","disorder","retrospective","prospective","effectiveness","study","santosh","baird","pityaratstian","tavare","gringras"],"keywords":["sep 20 import","duplicate"],"authorIDs":[],"dataSources":["pWG6kkFjeQheTxKbs"]}