Methylphenidate in Autism Spectrum Disorder: A Long-Term Follow Up Naturalistic Study
Abstract
:1. Introduction
1.1. ASD and ADHD
1.2. Psychotropic Drugs in ASD
1.3. MPH in ADHD with Comorbid ASD
2. Materials and Methods
2.1. Participants and Procedures
2.2. Statistical Analysis
3. Results
3.1. MPH Treatment
3.2. Primary Outcomes
3.2.1. CGI Measures
3.2.2. C-GAS Measures
3.2.3. Other Psychotropic Medications at the Last Follow-Up
3.2.4. Safety
3.2.5. Discontinuation Rate
3.3. Secondary Outcomes
3.3.1. Evaluation of Factors to Predict Amelioration in Severity of the Illness
3.3.2. Evaluation of Factors to Predict Clinical Improvement
3.3.3. Evaluation of Factors to Predict Amelioration in Global Functioning
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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ASD + ADHD Group (n = 40) | ADHD Group (n = 40) | p-Value | |||
---|---|---|---|---|---|
n | % | n | % | ||
Sex | |||||
M | 32 | 80 | 28 | 70 | |
F | 8 | 20 | 12 | 30 | 0.3047 |
Median | 95% CI | Median | 95% CI | ||
Age (years) | 15.5 | 14–17 | 15 | 14–17 | 0.7502 |
n | % | n | % | ||
ASD level | |||||
1 | 34 | 85 | |||
2 | 4 | 10 | |||
3 | 2 | 5 | |||
ADHD severity level | |||||
Severe | 12 | 30 | 14 | 35 | 0.6352 |
Moderate | 28 | 70 | 26 | 65 | |
ADHD specifiers | |||||
Inattentive | 8 | 20 | 6 | 15 | 0.5587 |
Combined | 32 | 80 | 34 | 85 | |
Median | 95% CI | Median | 95% CI | ||
Intelligence Quotient (IQ) | 89.5 | 84.33–101.66 | 98.5 | 86.33–104.32 | 0.4558 |
n | % | n | % | ||
Comorbidities | |||||
Learning disorder | 31 | 77.5 | 32 | 80 | |
Motor coordination disorder | 11 | 27.5 | 2 | 5 | |
Sleep–wake disorder | 10 | 25 | 11 | 27.5 | |
Anxiety disorder | 9 | 22.5 | 6 | 15 | |
Oppositional defiant disorder | 6 | 15 | 32 | 80 | |
Disruptive mood dysregulation disorder | 5 | 12.5 | 8 | 20 | |
Other psychotropic medications | |||||
Antipsychotics (FGA and SGA) | 11 | 27.5 | 7 | 17.5 | |
Mood stabilizer | 4 | 10 | 5 | 12.5 | |
Antidepressants | 2 | 5 | 1 | 2.5 | |
Anxiolytics | 1 | 2.5 | 0 | 0 | |
Melatonin | 8 | 20 | 9 | 22.5 |
ADHD + ASD | ADHD | p-Value | |||
---|---|---|---|---|---|
Age of therapy onset (Years) | Median (IQR) | 95% CI | Median (IQR) | 95% CI | 0.2309 |
9 (7–13) | 7–10 | 10 (8.5–13) | 9–11.6 | ||
MPH dose (mg/kg/day) | 0.6 (0.46–0.7) | 0.5–0.7 | 0.6 (0.46–0.825) | 0.52–0.7 | 0.6026 |
Therapy duration (months) | 36 (24–78) | 24–78 | 48 (36–57.97) | 24–72 | 0.5679 |
CGI-S | ASD + ADHD Group | ADHD Group | p-Value |
---|---|---|---|
T0 | n = 40 | n = 40 | |
Median Range (95% CI) | 5 4–7 (5–6) | 5 4–7 (5–6) | 0.5609 |
T1 | n = 40 | n = 40 | |
Median Range (95% CI) | 5 3–7 (4.5–5) | 5 3–6 (4–5) | 0.1138 |
T6 | n = 39 | n = 40 | |
Median Range (95% CI) | 4 2–7 (4–5) | 4 2–6 (3–4) | 0.0501 |
T24 | n = 37 | n = 39 | |
Median Range (95% CI) | 4 2–5 (3.4–4) | 3 2–6 (3–4) | 0.1104 |
p-value (T0–T24) | <0.0001 | <0.0001 | |
CGI-I | ASD + ADHD group | ADHD group | p-value |
T1 | n = 40 | n = 40 | |
Median Range (95% CI) | 3 2–5 (3–3) | 3 2–4 (3–3) | 0.9715 |
T6 | n = 39 | n = 40 | |
Median Range (95% CI) | 3 2–6 (2–3) | 2 2–4 (2–3) | 0.594 |
T24 | n = 37 | n = 39 | |
Median Range (95% CI) | 2 1–4 (2–3) | 2 1–4 (2–3) | 0.8116 |
p-value (T1–T24) | 0.00001 | <0.00001 | |
CGI-E | ASD + ADHD group | ADHD group | p-value |
Median Range (95% CI) | 2 0.25–3 (1.5–2) | 2 0.5–4 (1.5–2) | 0.7986 |
ASD + ADHD Group | ADHD Group | p-Value | |
---|---|---|---|
T0 Median Range (95% CI) | 43 25–50 (40–45) | 45 30–55 (45–47.66) | 0.0632 |
Last follow-up Median Range (95% CI) | 55 25–70 (50–58.32) | 60 40–70 (55–64.32) | 0.0907 |
p-value (T0–T24) | <0.0001 | <0.0001 |
ASD + ADHD Group n (%) | ADHD Group n (%) | p-Value | |
---|---|---|---|
Loss of appetite | 19 (47.5) | 23 (57.5) | 0.9865 |
Abdominal discomfort | 18 (45) | 14 (35) | 0.9792 |
Headache | 10 (25) | 6 (15) | 0.8147 |
Irritability | 4 (10) | 3 (7.5) | 1 |
Palpitation | 3 (7.5) | 1 (2.5) | 0.9974 |
Restlessness | 3 (7.5) | 1 (2.5) | 0.9974 |
Anxiety | 2 (5) | 0 | 0.97 |
Insomnia | 1 (2.5) | 2 (5) | 1 |
Dizziness | 1 (2.5) | 1 (2.5) | 1 |
Drowsiness | 0 | 0 | 1 |
Tic disorder | 0 | 0 | 1 |
Hallucinations | 0 | 0 | 1 |
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Ventura, P.; de Giambattista, C.; Spagnoletta, L.; Trerotoli, P.; Cavone, M.; Di Gioia, A.; Margari, L. Methylphenidate in Autism Spectrum Disorder: A Long-Term Follow Up Naturalistic Study. J. Clin. Med. 2020, 9, 2566. https://doi.org/10.3390/jcm9082566
Ventura P, de Giambattista C, Spagnoletta L, Trerotoli P, Cavone M, Di Gioia A, Margari L. Methylphenidate in Autism Spectrum Disorder: A Long-Term Follow Up Naturalistic Study. Journal of Clinical Medicine. 2020; 9(8):2566. https://doi.org/10.3390/jcm9082566
Chicago/Turabian StyleVentura, Patrizia, Concetta de Giambattista, Laura Spagnoletta, Paolo Trerotoli, Maddalena Cavone, Alessandra Di Gioia, and Lucia Margari. 2020. "Methylphenidate in Autism Spectrum Disorder: A Long-Term Follow Up Naturalistic Study" Journal of Clinical Medicine 9, no. 8: 2566. https://doi.org/10.3390/jcm9082566