Dopamine antagonists for treatment resistance in autism spectrum disorders

review and focus on BDNF stimulators loxapine and amitriptyline

Jessica A. Hellings, L. Eugene Arnold, Joan Han

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Introduction: Drug development and repurposing are urgently needed for individuals with autism spectrum disorders (ASD) and psychiatric comorbidity, which often presents as aggression and self-injury. Areas covered: We review dopamine antagonists, including classical and atypical, as well as unconventional antipsychotics in ASD. The older antipsychotic loxapine is discussed in terms of preliminary albeit limited evidence in ASD. Emerging promise of amitriptyline in ASD is discussed, together with promising BDNF effects of loxapine and amitriptyline. Expert opinion: In ASD, pharmacotherapy and specifically dopamine antagonist drugs are often prescribed for challenging behaviors including aggression. The novel antipsychotics risperidone and aripiprazole have received most study in ASD and are FDA-approved for irritability in children with ASD over age 5 years; individuals with ASD are prone to weight gain, Type II diabetes and associated side effects. Low dose loxapine has properties of classical and novel antipsychotics but importantly appears more weight neutral, and with promising use in adolescents and adults with ASD. Amitriptyline appears effective in ASD for irritability, aggression, gastrointestinal problems, and insomnia, in children, adolescents and adults however our adult data on amitriptyline in ASD is still in preparation for publication. Both loxapine and amitriptyline may stimulate BDNF; further studies are warranted.

Original languageEnglish (US)
Pages (from-to)581-588
Number of pages8
JournalExpert Opinion on Pharmacotherapy
Volume18
Issue number6
DOIs
StatePublished - Apr 13 2017

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Loxapine
Amitriptyline
Dopamine Antagonists
Brain-Derived Neurotrophic Factor
Antipsychotic Agents
Aggression
Therapeutics
Autism Spectrum Disorder
Drug Repositioning
Dopamine Agents
Risperidone
Expert Testimony
Sleep Initiation and Maintenance Disorders
Type 2 Diabetes Mellitus
Weight Gain
Psychiatry

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

Cite this

Dopamine antagonists for treatment resistance in autism spectrum disorders : review and focus on BDNF stimulators loxapine and amitriptyline. / Hellings, Jessica A.; Arnold, L. Eugene; Han, Joan.

In: Expert Opinion on Pharmacotherapy, Vol. 18, No. 6, 13.04.2017, p. 581-588.

Research output: Contribution to journalReview article

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