Randomised controlled trials of mood stabilisers for people with autism spectrum disorder: systematic review and meta-analysis
Roy, Meera Lee, Rachel Taiwo, Oluwafemi
Roy, Meera
Lee, Rachel
Taiwo, Oluwafemi
Citations
Altmetric:
Affiliation
Imperial College, London; Hereford and Worcestershire Health and Care Trust; Coventry and Warwickshire Partnership NHS Foundation Trust; Warwick Medical School, University of Warwick
Other Contributors
Publication date
2022-02-24
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Background
Despite the widespread use of psychotropic medications in people with autism spectrum disorder (ASD), there is limited evidence to suggest that psychotropic medications including mood stabilisers are effective in individuals with ASD.
Aims
To carry out a systematic review and meta-analysis of randomised controlled trials (RCTs) that assessed the effectiveness of mood stabilisers in people with ASD.
Method
We searched the following databases: Cochrane Library, MEDLINE, Embase, CINAHL, PsycINFO, ERIC, DARE, and ClinicalTrials.gov. In addition, we hand-searched 12 relevant journals. We used the Cochrane Risk of Bias and Jadad scores to assess the quality of included RCTs. We carried out a meta-analysis using a random-effects model.
Results
We included eight RCTs (four on valproate, two on levetiracetam, and one each on lamotrigine and topiramate) that included a total of 310 people with ASD, primarily children. Outcomes were based on core and associated ASD symptoms including irritability and aggression but not bipolar disorder. Only two small studies (25%) from the same group showed definite superiority over placebo and one over psychoeducation alone. Meta-analysis of pooled data on the Aberrant Behaviour Checklist-irritability, Clinical Global Impression Scale-improvement, and Overt Aggression Scale (OAS)/OAS-modified did not show any significant inter-group difference. The rates of adverse effects did not show any significant inter-group difference.
Conclusions
Given the methodological flaws in the included studies and the contradictory findings, it is difficult to draw any definitive conclusion about the effectiveness of mood stabilisers to treat either ASD core symptoms or associated behaviours. Robust large-scale RCTs are needed in the future to address this issue.
Citation
Limbu B, Deb S, Roy M, Lee R, Roy A, Taiwo O. Randomised controlled trials of mood stabilisers for people with autism spectrum disorder: systematic review and meta-analysis. BJPsych Open. 2022;8(2):e52. doi:10.1192/bjo.2022.18
Type
Article