Aripiprazole in autism spectrum disorder: current evidence for use

This month's Cochrane Corner meta-analysis evaluates the evidence for the use of aripiprazole in 'autism spectrum disorders' - although in fact, outcome measures mainly included subtypes of challenging behaviour and side-effects. Aripiprazole was found to be effective in reducing irritability and hyperactivity, while causing extrapyramidal side-effects and weight gain. Only three trials were included in the review, with two small trials eventually included in the meta-analysis. All trials were conducted in under-18s in the USA, with no requirement for a trial of behavioural management before psychotropic medication, and excluding under-18s with important comorbidities such as medicated attention-deficit hyperactivity disorder. All three studies were sponsored and funded by the manufacturer of aripiprazole. Further, a discontinuation trial showed no evidence of sustained benefit beyond 16 weeks of treatment.