Start low, go slow... JR
Trial shows low-dose anti-anxiety med helps curb autism behaviors in young children
December 30, 2015
Diane Chugani, Ph.D.
The anti-anxiety medication Buspirone is effective in low doses in improving repetitive and restrictive behaviors in young children with autism, and may be useful combined with early intensive behavioral interventions that improve social communication and adaptive behavior.
The discovery is the result of a multi-year, multi-center clinical trial led by Wayne University School of Medicine autism researcher Diane Chugani, Ph.D., and published today in The Journal of Pediatrics.
Autism spectrum disorder is a neurodevelopmental condition characterized by impairment in social communication and presence of repetitive and restricted behaviors, including persistent strong interest in specific objects and unusual topics, speech echolalia, repetitive hand and body movements such as hand-flapping, spinning and odd posturing.
Dr. Chugani is a professor of Pediatrics at the School of Medicine and chief of the Division of Clinical Pharmacology and Toxicology at the Detroit Medical Center Children’s Hospital of Michigan.
“I think any research that shows some benefit gives families some hope. They hope for more – a cure – but help with some of the symptoms can be very meaningful for everyday life,” she said.
The U.S. Centers for Disease Control and Prevention reports ASD is the fastest-growing developmental disability in the country, with approximately one in 68 children diagnosed nationwide. The Michigan Department of Education reported 17,986 children with ASD in special education programs during the 2014-15 school year. The annual growth rate has averaged 7 percent to 8 percent over the last five years.
Buspirone, also known by brand names BuSpar and Vanspar, is already an approved treatment for children with anxiety, a comorbid condition in ASD. In the study, “Efficacy of Low Dose Buspirone for Restricted and Repetitive Behavior in Young Children with Autism Spectrum Disorder: A Randomized Trial,” 166 children with ASD ranging from 2 to 6 years old were randomized to receive a placebo, or 2.5 mg or 5.0 mg of buspirone twice a day for two 24-week phases. Children who were given 2.5 mg of the medicine showed significant improvement in restricted and repetitive behaviors.
Using positron emission tomography, Dr. Chugani discovered in the late 1990s that changes in serotonin syntheses that occur with age are not present in autistic children.
Recent studies suggest that risk for ASD is conferred by rare variants in hundreds of genes that converge on networks related to neuronal signaling and development. Dr. Chugani designed the study based on in vivo imaging data in children with ASD.
Before treatment with the drug, the children underwent PET and blood studies to evaluate whether Buspirone response could be predicted by brain tryptophan metabolism or blood serotonin levels. “Since serotonin function is important in postnatal brain development, we hypothesized that one approach to the treatment of core features of ASD pharmacologically would be the use of serotonin agonists in children younger than 6 years, when their brain serotonin synthesis capacity is lower than in children without ASD,” Dr. Chugani wrote.
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