Global research landscape in pharmacotherapy for autism spectrum disorder core symptoms: a bibliometric study

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social communication deficits and repetitive behaviors. While non-pharmacological interventions are primary, pharmacotherapy targeting core symptoms has gained attention despite challenges from ASD's heterogeneity and limited effective treatments. Bibliometric analysis provides a systematic overview of research trends, especially in early pharmacotherapy development. This study aims to evaluate the global research landscape and trends in pharmacotherapy for the core symptoms of ASD through bibliometric analysis.

This study applied bibliometric methods to analyze 109 English publications [1993-2025] from the Web of Science focusing on ASD pharmacotherapy. Using R (biblioshiny), co-citation, co-word, co-authorship, and source citation analyses were performed to map the global research landscape, identify key contributors, trace thematic evolution, and reveal emerging trends.

Findings showed a significant rise in pharmacotherapy research, driven largely by international collaborations, notably involving the USA and Australia. Citation networks centered on neurotransmitter systems (serotonin, dopamine). Four research clusters were identified: (I) repetitive behaviors (risperidone, fluoxetine, melatonin); (II) social behavior/neuropeptides (vasopressin, oxytocin); (III) novel mechanisms (memantine, aripiprazole, atomoxetine); and (IV) adjunctive treatments. Established drugs showed partial efficacy, while new targets and combination strategies gained prominence.

This bibliometric study offers a comprehensive view of ASD pharmacotherapy research, highlighting international collaboration and distinct themes. It underscores the need for more targeted, effective, and safe treatments and advocates further research into novel mechanisms, combination therapies, and standardized assessments to improve clinical outcomes.