St John's Wort treating patients with autistic disorder

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• Pervasive developmental disorders present challenges in social interaction and communication.
• Educational and behavioral interventions may be limited by symptoms like poor eye contact and expressive language deficits.
• Pharmacological interventions are sometimes considered to manage core symptoms of autistic disorder.

Purpose of the Study:

• To investigate the preliminary efficacy of St. John's Wort as an adjunctive treatment for autistic disorder.
• To assess the impact of St. John's Wort on specific symptoms including eye contact, expressive language, and irritability.
• To evaluate St. John's Wort in patients who have not responded to or tolerated other psychopharmacological treatments.

Main Methods:

• A preliminary open-label trial involving three male patients diagnosed with autistic disorder (ICD-10 criteria).
• Participants had inadequate eye contact and expressive language for their developmental level and prior treatment failures.
• St. John's Wort was administered, and outcomes were assessed using parent/mentor ratings (Aberrant Behavior Checklist) and clinician ratings (Psychiatric Rating Scale, Global Assessment Scale, Clinical Global Impressions).

Main Results:

• Parent and mentor ratings indicated slight improvements in irritability, stereotypy, and inappropriate speech factors.
• Clinician ratings did not show significant improvements across assessed factors, including autism, anger, and speech deviance.
• St. John's Wort demonstrated modest short-term effectiveness primarily for irritability in some patients.

Conclusions:

• St. John's Wort may offer a modest, short-term benefit for irritability in a subset of patients with autistic disorder.
• Further research with larger sample sizes and controlled designs is warranted to confirm these preliminary findings.
• The limited efficacy suggests St. John's Wort is not a primary treatment for core symptoms of autistic disorder but may be considered for specific symptom management.