Antidepressants and anticonvulsants/mood stabilizers in the treatment of autism

Many medications have been used to ameliorate autistic symptoms and behaviors in individuals with autism. Currently, there are no pharmacological treatments with established indications for autism (1). However, psychotropic medications have been used in autistic individuals to target core symptoms, behavioral dyscontrol, treatment of concurrent psychiatric disorders, and management of associated medical conditions such as seizures. Antidepressant medications, particularly serotonin-reuptake inhibitors (SRIs), and anticonvulsant medications are among the medications commonly used for autism spectrum behaviors. The SRIs used include clomipramine (Ananfranil), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), and venlafaxine (Effexor). Some of these medications have been studied in an open-label as well as double-blind manner. The results of these studies generally indicate that these medications are efficacious in treating some of the symptoms of individuals with autism spectrum disorder. Anticonvulsants, such as valproic acid and carbamazepine, are used particularly in individuals with comorbid seizure disorder, as well as those with impulsive aggression and affective instability. However, to date no placebo-controlled trials have been published examining the efficacy of these medications. There have, however, been case reports and open-label retrospective studies suggesting the efficacy of these medications in autistic individuals.