Medication Treatment For Attention Deficit Hyperactivity Disorder In Children With Autism Spectrum Disorders. Classification Problems And Evidence From Literature

Background: Attention-deficit hyperactivity disorder (ADHD) is a heterogeneous constellation of complex neurodevelopmental problems, with prevalence ranging from 1.5% to 7% according to criteria used.  In DSM-IV ADHD criteria, Autism Spectrum Disorders (ASD) are exclusionary criteria for ADHD diagnosis however there is increasing evidence that both conditions can co-exist.

Objectives: We will review studies examining the effectiveness of medication treatment for ADHD in people with ASD.

Methods: Electronic Searches will be used to identify all studies of medication for ADHD in people with ASD. The primary outcome studied will be change in symptoms of attention deficit and hyperactivity.

Results: A number of studies provide evidence that first line ADHD treatment (stimulants) can be effective in children with ASD however the response rate is decreased and the adverse effects increased compared to the general population. Risperidone has been studied also and it is considered effective for ADHD symptoms. Atomoxetine, introduced more recently in the treatment of ADHD, was proved well tolerated and effective for reducing ADHD symptoms in a small open label trial and a cross over trial.

Conclusions: Treatment of ADHD symptoms can enhance social and occupational adaptation, prevent aspects of co-morbidity and increase self-esteem and quality of life in children and adults with ASD. Literature suggests that ADHD medication can be effective in the ASD population although Randomized Controlled Trials are still lacking.