Long-Term Aripiprazole in Youth With Developmental Disabilities Including Autism

We retrospectively reviewed clinic charts of 21 children and adolescents with developmental disabilities including autism spectrum disorders (ASD) treated consecutively with aripiprazole (ARI) for irritability and severe challenging behaviors. Data extracted include age, sex, and race; level of intellectual disability (ID); Diagnostic and Statistical Manual-IV diagnoses including comorbidity, ARI dosage, and treatment duration; other psychoactive medications and Clinical Global Impressions-Improvement (CGI-I) at baseline and end point; weight; height; and side effects. Body mass index (BMI) z scores are compared with Centers for Disease Control norms. Eleven boys and 10 girls with ID and/or ASD ages 8 to 18 years (mean age 13.4 years) received ARI; mean dose was 8.4 mg/day (range 2.5 to 15); average duration was 60.6 weeks (7 to 132). Eleven of 21 patients (52%) met CGI-I response of ≤ 2. ARI was well tolerated, including together with stimulants, divalproex, or less commonly other medications. Mean BMI was 23.8 ± 5.9 at baseline and 24.2 ± 5.2 at end. Mean BMI z score increase was 0.06 ± 0.67. Four individuals (19%) manifested early intolerable weight gain. In this long-term clinical sample, ARI was effective in 52% and well tolerated. ARI was mostly weight neutral; early weight gain was intolerable in 19%. Larger long-term outcome studies are warranted in this population.