Section - CAP Smart Takes

02. Efficacy of Pharmacologic Interventions for Irritability and Emotional Dysregulation in ASD

Published on May 1, 2023 Certification expiration date: May 1, 2026

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Aripiprazole and risperidone effectively treat short-term irritability and emotional dysregulation in patients with ASD, but they are not a one-size-fits-all solution.
Behavioral and psychosocial interventions should be started before pharmacologic interventions whenever possible.
Patients with ASD are susceptible to medication side effects; consider the potential adverse events when prescribing medications such as risperidone and aripiprazole.

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Hi! David Rosenberg here for the Psychopharmacology Institute. In this CAP—or Child and Adolescent Psychiatry—Smart Take, we will examine whether and which pharmacologic interventions are effective for treating irritability and emotional dysregulation in autism spectrum disorder (ASD) and whether there are any good predictors of treatment response or lack thereof. De Pablo and colleagues conducted a comprehensive and systematic meta-analysis studying nearly 3,000 individuals with ASD, which included 45 studies. And interestingly, they noted that nearly 30% of the randomized controlled trials (RCTs) had a high risk for bias. So, this problem raises matters and concerns when we analyze these RCTs. The average age of the patients with ASD was 11 years old. And not surprisingly, most—or 66%—were male.

So, what did they find? Again, not surprisingly, as they are FDA medications approved for treating irritability and ASD, aripiprazole and risperidone showed clear efficacy in treating short-term irritability and emotional

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03. Psychopharmacologic Treatment Algorithms for Bipolar Disorder in Youth

Learning Objectives:

Understand that upset stomach and vomiting can be reliable predictors of medication nonadherence in adolescents and young adults with ADHD.
Identify the first-line pharmacologic interventions for treating irritability and emotional dysregulation in patients with ASD.
Understand the current state of best practice treatment algorithms for pediatric bipolar disorder, specifically manic/mixed and depressive episodes.
Identify the most commonly prescribed antipsychotics for children and adolescents, as well as the most common reasons for their use.
Explain the importance of considering cost-effectiveness in treatment decisions for ADHD and ASD in children and adolescents, and describe how it can impact treatment access and outcomes.

Original Release Date: May 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: May 1, 2026

Expert: David Rosenberg, M.D.

Medical Editor: Lorena Rodriguez, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.