- Atypical antipsychotic agent
- Kuwait, clinical trial
Objectives: To study the efficacy and safety of olanzapine for the treatment of children with autism associated with disruptive behavior problems. Subjects and Methods: A prospective open-label trial was conducted on 40 male children (mean age 12.2 ± 2.2 years, range 7–17 years) meeting Diagnostic Statistical Manual IV criteria for autism. After a washout period from previous medications (2–14 days), patients received olanzapine (5–10 mg/day) for a 13-week treatment period. The primary efficacy measures were Aberrant Behavior Checklist (ABC) and Clinical Global Impressions-Severity (CGI-S) done at baseline and end of treatment. At the beginning and end of treatment, patients underwent laboratory and physical investigations: ECG, chest X-ray, urinalysis, serum chemistry, blood glucose and lipid profile, hematology and hepatitis B serology. Results: Paired comparison of baseline and 13-week endpoint scores showed significant reductions in ABC subscale scores for irritability (p < 0.0001), lethargy (p < 0.0001), stereotyped behavior (p < 0.005), hyperactivity (p < 0.0001) and inappropriate speech (p < 0.005). Of 40 patients, 12 (30%) were considered as ‘improved’ on CGI-S scores compared to baseline, a statistically significant difference (p < 0.05). No liver enzyme elevation or any other serum biochemical changes resulted from treatment, which was not associated with significant body weight changes or any other treatment-emergent side effects. Conclusions: The study shows that olanzapine treatment can be beneficial in alleviating some behavioral symptoms (irritability, hyperactivity/noncompliance and lethargy/withdrawal) associated with autism. The short period of this trial limits inferences about adverse effects such as body weight increase and tardive dyskinesia. Further long-term placebo-controlled studies of olanzapine are required.
Copyright © 2008 S. Karger AG, Basel
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 2002.
- Frombonne E: Epidemiological surveys of autism and other pervasive developmental disorders: an update. J Autism Dev Disord 2003;33:365–382.
- The Annual Statistical Abstract. Kuwait Autism Society 2006;2:51–58.
- Bailey A, Lecouteur A, Gottesman J: Autism as a strongly genetic disorder: evidence from a British twin study. Psychol Med 1995;25:63–77.
- Piven J, Palmer P, Jacobi D: The broader autism phenotype: evidence from a family study of multiple-incidence autism families. Am J Psychiatry 1997;154:185–190.
- Sykes NH, Lamb JS: Autism: the quest for the genes. Expert Rev Mol Med 2007;9:1–15.
- Whitely P: A gluten-free diet as an intervention for autism and associated spectrum disorders: preliminary findings. Autism 1999;3:45–65.
- Murch S: Diet, immunity, and autistic spectrum disorders. J Pediatr 2005;146:582–584.
- Janusonis S: Statistical distribution of blood serotonin as a predictor of early autistic brain abnormalties. Theor Biol Med Model 2007;19:2–27.
- Fido A, Dashti H, Al-Saad S: Biological correlates of childhood autism: ‘trace elements’. Trace Elem Electrol 2002;19:1–4.
- Fido A, Al-Saad S: Toxic trace elements in the hair of children with autism. Autism 2005;9:290–298.
- Dosman CF, Brian JA, Drmic IE: Children with autism: effect of iron supplementation on sleep and ferritin. Pediatr Neurol 2007;36:152–158.
- Adams JB, Romdalvik J, Ramanujam VM: Mercury, lead, and zinc in baby teeth of children with autism versus controls. J Toxicol Environ Health 2007;70:1046–1051.
- Horner RH, Carr EG, Strain PS: Problem behavior interventions for young children with autism: a research synthesis. J Autism Dev Disord 2002;32:423–446.
- Hagopian LP, Pruzek JL, Bowman LG: Assessment and treatment of problem behavior occasioned by interruption of free-operant behavior. J Appl Behav Anal 2007;40:89–103.
- Jerome J, Frantino E, Sturmey P: The effects of errorless learning and backward chaining on the acquisition of internet skills in adults with developmental disabilities. J Appl Behav Anal 2007;40:185–189.
- Posey DJ, McDougle CJ: The pharmacotherapy of target symptoms associated with autistic disorder and other pervasive developmental disorders. Harv Rev Psychiatry 2000;8:45–63.
- Aman MG: Management of hyperactivity and other acting-out problems in patients with autism spectrum disorder. Semin Pediatr Neurol 2004;11:225–228.
- Malone R, Maislin G, Choudhury M: Risperidone treatment in children and adolescents with autism: short-and long-term safety and effectiveness. Am Acad Child Adolesc Psychiatry 2002;41:140–147.
- McCracken J, Mcgough J, Shah B: Risperidone in children with autism and serious behavioral problems. N Engl J Med 2002;347:314–321.
- Padina GJ, Bossie CA, Yousef E: Risperidone improves symptoms in children with autism in a randomized, double-blind, placebo-controlled trial. Autism Dev Disord 2007;37:367–373.
- West L, Waldrop J: Risperidone use in the treatment of behavioral symptoms in children with autism. Pediatr Nursing 2006;32:550–555.
- Potenza MN, Holmes JP, Kanes SJ: Olanzapine treatment of children, adolescents, and adults with pervasive developmental disorders: an open-label pilot study. J Clin Psychopharmacol 1999;19:37–44.
- Malone R, Cater J, Sheikh R: Olanzapine versus haloperidol in children with autistic disorder: an open pilot study. J Am Child Adolesc 2001;40:887–894.
- Kemner C, Willemsen S, Sophie H: Open-label study of olanzapine in children with pervasive developmental disorder. J Clin Psychopharmacol 2002;22:455–460.
- Barnes TR: A rating scale for drug-induced akathisia. Br J Psychiatry 1989;154:672–676.
- Aman MG, Singh NN, Stewart AW: The Aberrant Behavior Checklist: a behavior rating scale for the assessment of treatment effects. Am J Ment Defic 1985;89:485–491.
- Hollander E, Wasserman S, Swanson EN: A double-blind placebo-controlled pilot study of olanzapine in childhood/adolescent pervasive developmental disorder. J Child Adolesc Psychopharmacol 2006;16:541–548.
Dr. Abdullahi Fido, MD, MRCPsych
Department of Psychiatry, Faculty of Medicine, Health Sciences Centre
Kuwait University, PO Box 24923
Safat 13110 (Kuwait)
Tel. +965 533 0467, Fax +965 533 8904, E-Mail email@example.com
Received: July 18, 2007
Revised: October 9, 2007
Published online: August 06, 2008
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 1, Number of References : 28
Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre)
Vol. 17, No. 5, Year 2008 (Cover Date: August 2008)
Journal Editor: Owunwanne A. (Kuwait)
ISSN: 1011–7571 (Print), eISSN: 1423–0151 (Online)
For additional information: http://www.karger.com/MPP
Open Access License / Drug Dosage / Disclaimer
Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license
), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.