Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: A chart review study

Benjamin A. Adler, Logan K. Wink, Maureen Early, Rebecca Shaffer, Noha Minshawi, Christopher J. McDougle, Craig A. Erickson

Research output: Contribution to journalReview article

37 Scopus citations

Abstract

Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drugrefractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p < 0.0001), diagnosis of autistic disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain.

Original languageEnglish (US)
Pages (from-to)102-106
Number of pages5
JournalAutism
Volume19
Issue number1
DOIs
StatePublished - Jan 19 2015

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Keywords

  • Aggression
  • Atypical antipsychotics
  • Autism
  • Autism spectrum disorders
  • Self-injurious behavior
  • Severe tantrums

ASJC Scopus subject areas

  • Developmental and Educational Psychology

Cite this

Adler, B. A., Wink, L. K., Early, M., Shaffer, R., Minshawi, N., McDougle, C. J., & Erickson, C. A. (2015). Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: A chart review study. Autism, 19(1), 102-106. https://doi.org/10.1177/1362361314524641