title: Treating autistic spectrum disorders in children: utility of the cholinesterase inhibitor rivastigmine tartrate.
abstract: Rivastigmine tartrate is a dual-action cholinesterase inhibitor shown to improve language, cognition, and global functioning in patients with Alzheimer's disease, likely via increased availability of cerebral acetylcholine. Because cholinergic receptor abnormalities can contribute to the neuropathology of autistic spectrum disorders, rivastigmine tartrate could prove to be an effective therapy for affected children. Observations of improved behavior and language output from prior open-label and double-blind treatment of autistic children with donepezil, another cholinesterase inhibitor, prompted this 12-week open-label study with rivastigmine tartrate of 32 autistic patients. Therapeutic indices were the Childhood Autistic Rating Scale, Gardner's Expressive and Receptive One-Word Picture Vocabulary tests, and the Conners' Parent Rating Scale. Testing administered at baseline, 6 weeks, and 12 weeks showed gains in both expressive speech and overall autistic behavior over baseline. These improvements were statistically significant and supported the hypothesis that treatment with cholinergic enhancing drugs in autistic spectrum disorders yields positive therapeutic effects.
authors.affiliation: Autism and Epilepsy Specialty Services of Illinois, Ltd., USA. mchezmd@sbcglobal.net
authors.forename: Michael G
authors.initials: MG
authors.lastname: Chez
authors.forename: Mary
authors.initials: M
authors.lastname: Aimonovitch
authors.forename: Thomas
authors.initials: T
authors.lastname: Buchanan
authors.forename: Susan
authors.initials: S
authors.lastname: Mrazek
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Tremb
mesh_terms: D000109:Acetylcholine / Q000378:metabolism; D001321:Autistic Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001921:Brain / Q000187:drug effects; D002219:Carbamates / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D007805:Language Development Disorders / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual / Q000187:drug effects; D010552:Personality Assessment; D048448:Phenylcarbamates; D000068836:Rivastigmine; D012919:Social Behavior; D016896:Treatment Outcome; D014825:Vocabulary
chemical_list: D002219:Carbamates; D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D000109:Acetylcholine; D000068836:Rivastigmine