title: Atypical antipsychotics in the treatment of children and adolescents with pervasive developmental disorders.
abstract: BACKGROUND
  Autism and related pervasive developmental disorders (PDD) are characterized by impairments in social interaction and communication, restricted interests, and repetitive and stereotyped patterns of behavior. Individuals with PDD frequently display irritability and disruptive behaviors including tantrums, self-injurious behavior, and aggression. Atypical antipsychotics are currently the most efficacious pharmacological interventions available for treatment of irritability associated with PDD.
  
  
  OBJECTIVE
  This article aims to review the body of literature pertaining to the use of atypical antipsychotics in the treatment of patients with PDD.
  
  
  METHODS
  A PubMed literature search was conducted using the following key words: autism, pervasive developmental disorders, atypical antipsychotics, risperidone, aripiprazole, quetiapine, ziprasidone, olanzapine, clozapine, paliperidone, iloperidone, asenapine, and lurasidone. Search terms were limited to English language, human subjects, and publication from 1999 to present. Relevant references from identified articles were also reviewed.
  
  
  RESULTS
  The efficacy and tolerability of risperidone and aripiprazole for the treatment of irritability in autism have been established with multi-site, randomized, controlled trials. Studies supporting the use of other atypical antipsychotics are either limited in scope or less robust in their findings, though newer agents such as ziprasidone and paliperidone show promise.
  
  
  CONCLUSIONS
  Atypical antipsychotics are currently first-line pharmacological agents for the treatment of irritability and associated behaviors in children with PDD. Further placebo-controlled studies are warranted to characterize the efficacy and tolerability of the majority of these medications. There is also a need for the development of novel, targeted drugs with more favorable long-term side effect profiles.
authors.affiliation: Department of Psychiatry and Pediatrics, Lurie Center for Autism, Massachusetts General Hospital, MassGeneral Hospital for Children, Harvard Medical School, Lexington, MA, 02421, USA, lpolitte@partners.org.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Politte
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McDougle
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000188:drug therapy*; D006801:Humans; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic
chemical_list: D014150:Antipsychotic Agents
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