[Pharmacological interventions for intellectual disability and autism]

Area of Science:

• Neuroscience
• Developmental Psychology
• Pharmacology

Background:

• Intellectual disability (ID) and autism spectrum disorder (ASD) lack proven core-symptom treatments.
• Psychotropic medications are widely used for psychiatric symptoms in ID/ASD populations, despite limited evidence.
• Existing treatments primarily address associated symptoms rather than core deficits.

Purpose of the Study:

• To review current evidence on the efficacy of pharmacological interventions for common symptoms and disorders linked to ID and ASD.
• To identify novel molecules under investigation for treating the core symptoms of these developmental conditions.
• To provide a comprehensive overview of the pharmacotherapy landscape for ID and ASD.

Main Methods:

• Systematic literature search of electronic databases, supplemented by hand searches.
• Narrative data synthesis, prioritizing meta-analyses and randomized controlled trials (RCTs).
• Inclusion of open-label trials and preliminary studies to capture broader evidence.

Main Results:

• Risperidone and aripiprazole demonstrated efficacy in reducing irritability associated with ID and ASD.
• Methylphenidate and atomoxetine showed effectiveness for hyperactivity and attention deficits.
• Evidence for other drug classes remains inconclusive; novel agents show mixed results with low-quality evidence.

Conclusions:

• Pharmacotherapy offers limited options for core ID/ASD symptoms, with specific drugs targeting associated psychiatric and attention issues.
• Novel therapeutic agents are emerging, with potential for future biologically targeted and individualized treatments.
• Clinicians must exercise caution, balancing risks and benefits, and integrating pharmacotherapy within personalized, comprehensive care plans.