Antiepileptic medications in autism spectrum disorder: a systematic review and meta-analysis.
Electroencephalogram-recorded epileptiform activity is common in children with autism spectrum disorder (ASD), even without clinical seizures. A systematic literature search identified 7 randomized, placebo-controlled trials of antiepileptic drugs (AEDs) in ASD (total n = 171), including three of valproate, and one each of lamotrigine, levetiracetam, and topiramate. Meta-analysis revealed no significant difference between medication and placebo in four studies targeting irritability/agitation and three studies investigating global improvement, although limitations include lack of power and different medications with diverse actions. Across all seven studies, there was no significant difference in discontinuation rate between two groups. AEDs do not appear to have a large effect size to treat behavioral symptoms in ASD, but further research is needed, particularly in the subgroup of patients with epileptiform abnormalities.
Department of Psychiatry, Vanderbilt University Medical Center, 1601 23rd Avenue South 3102 VPH, Nashville, TN, 37212, USA, tomoya.hirota@vanderbilt.edu.
Tomoya
T
Hirota
Jeremy
J
Veenstra-Vanderweele
Eric
E
Hollander
Taro
T
Kishi
D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000188:drug therapy* / Q000523:psychology; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007508:Irritable Mood / Q000187:drug effects*; D000077213:Lamotrigine; D000077287:Levetiracetam; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077236:Topiramate; D014227:Triazines / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D000077236:Topiramate; D005632:Fructose; D000077287:Levetiracetam; D000077213:Lamotrigine; D010889:Piracetam