title: [Pharmacological treatments in patients with pervasive developmental disorders: A review].
abstract: BACKGROUND
  Pervasive developmental disorders (PDD) are neurodevelepmental disorders that are characterized by severe deficits in socialisation and communication, and the existence of repetitive and stereotyped interests and behaviours. It is estimated more than 60/100,000 children are suffering from PDD. Comorbid disorders are common in people with PDD, including intellectual deficiency, symptoms of attention deficit-hyperactivity, aggression and disruption, and pervasive repetitive behaviours or thoughts. These symptoms have a negative impact on the outcome and quality of life of the patients and their caregivers. The first-line management of comorbid disorders in PDD is behavioural intervention, but sometimes this is not sufficient, and the use of pharmacological treatment is needed.
  
  
  METHODS
  We conducted a review of studies of medical treatments used in patients with PDD to establish which treatments show good evidence of efficacy in PDD. We used the Medline database and the following keywords "pervasive development disorders" or "autism spectrum disorders" or "autistic disorder" and "therapy" or "treatment".
  
  
  RESULTS
  The treatments that showed the best efficacy on irritability in well-designed studies are second generation antipsychotics, risperidone and aripiprazole. Some studies indicate that haloperidol is efficient as well, but the very high frequency of extra-pyramidal effects limits its use. Methylphenidate has shown some efficacy on impulsivity and hyperactivity in randomised placebo-controlled studies. First data concerning atomoxetine are promising but better-designed studies are needed. Selective serotonin re-uptake inhibitors: fluvoxamine and fluoxetine have shown some efficacy in the treatment of serious and pervasive repetitive behaviours. Alpha-adrenergic treatments, clonidine and guanfacine, can help in the management of disruptive behaviours in patients with PDD. Data concerning naltrexone are contradictory, indeed many case reports of its efficacy on aggressive (mostly auto-aggressive) behaviours are reported in the literature, but well-designed studies do not find any improvement in patients treated with naltrexone compared with patients treated with placebo. First data concerning ocytocin are promising, indeed, if they were to be confirmed, that would be the first treatment efficient on the core symptoms of PDD.
authors.affiliation: Service hospitalo-universitaire, centre hospitalier Sainte-Anne, 7, rue Cabanis, 75014 Paris, France; Pôle de psychiatrie générale de Rouen-rive-Droite, centre hospitalier du Rouvray, 76300 Sotteville-les-Rouen, France. Electronic address: laurenebeherec@hotmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Béhérec
authors.affiliation: Centre de ressource autisme de Haute-Normandie, centre hospitalier du Rouvray, 76300 Sotteville-les-Rouen, France.
authors.forename: G
authors.initials: G
authors.lastname: Quilici
authors.affiliation: Centre de ressource autisme de Haute-Normandie, centre hospitalier du Rouvray, 76300 Sotteville-les-Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Rosier
authors.affiliation: Psychiatrie de l'enfant et de l'adolescent, pôle Femme-Mère-Enfant, CHU Charles-Nicolle, 76031 Rouen, France.
authors.forename: P
authors.initials: P
authors.lastname: Gerardin
authors.affiliation: Pôle de psychiatrie générale de Rouen-rive-Droite, centre hospitalier du Rouvray, 76300 Sotteville-les-Rouen, France; Unité 614 de l'Inserm, université de Rouen, faculté de médecine et pharmacie, 22, boulevard Gambetta, 76183 Rouen cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Campion
authors.affiliation: Pôle de psychiatrie générale de Rouen-rive-Droite, centre hospitalier du Rouvray, 76300 Sotteville-les-Rouen, France; Centre de ressource autisme de Haute-Normandie, centre hospitalier du Rouvray, 76300 Sotteville-les-Rouen, France; Unité 614 de l'Inserm, université de Rouen, faculté de médecine et pharmacie, 22, boulevard Gambetta, 76183 Rouen cedex, France.
authors.forename: O
authors.initials: O
authors.lastname: Guillin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D002675:Child, Preschool; D003142:Communication; D015897:Comorbidity; D006801:Humans; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use; D012951:Socialization; D013239:Stereotyped Behavior; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: Autism spectrum disorders; Autistic disorder; Pervasive development disorders; Review; Revue de la littérature; Therapy; Thérapie; Treatment; Trouble autistique; Troubles envahissants du développement (TED); Troubles liés à l’autisme