A Retrospective Study of Amitriptyline in Youth with Autism Spectrum Disorders

• Published in: Journal of autism and developmental disorders 2013-05, Vol.43 (5), p.1017-1027
• Main Authors: Bhatti, Irfan, Thome, Andrew, Smith, Patricia Oxler, Cook-Wiens, Galen, Yeh, Hung Wen, Gaffney, Gary R., Hellings, Jessica A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adrenergic Uptake Inhibitors - therapeutic use; Aggression; Amitriptylene; Amitriptyline; Amitriptyline - therapeutic use; Anxiety Disorders; Atomoxetine Hydrochloride; Autism; Autism Spectrum Disorders; Autistic spectrum disorders; Behavior Problems; Behavioral Science and Psychology; Biological and medical sciences; Child; Child and School Psychology; Child clinical studies; Child Development Disorders, Pervasive - drug therapy; Child, Preschool; Complications and side effects; Developmental disorders; Dosage; Dosage and administration; Drug Therapy; Female; Humans; Hyperactivity; Impulsivity; Infantile autism; Male; Medical sciences; Neuropharmacology; Neurosciences; Original Paper; Outcomes of Treatment; Pediatrics; Pervasive Developmental Disorders; Pharmacology. Drug treatments; Prognosis; Propylamines - therapeutic use; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Public Health; Retreatment; Retrospective Studies; Symptoms (Individual Disorders); Treatment Outcome; Young people; Youth
• ISSN: 0162-3257; 1573-3432
• DOI: 10.1007/s10803-012-1647-0

We performed a retrospective chart review of 50 youths with Autism Spectrum Disorder (ASD), prescribed amitriptyline (AMI) for hyperactivity and impulsivity. Data was systematically extracted from 50 outpatient clinic charts, including AMI treatment duration, dose, trough levels and adverse events. Mean age was 9.4 years (4.6–17.9); 40 were males and 10 females. 30 % had failed atomoxetine and 40 % had failed ≥3 ADHD medications. Mean dose was 1.3 ± 0.6 mg/kg/day, mean trough level 114.1 ± 50.5 ng/ml, mean duration 3.4 years. Clinical Global Impressions Scale-Improvement (CGI-I) was ≤2 in 60 % of patients at the final visit, and in 82 % of patients for at least 50 % of follow-ups. Cautious use of low dose AMI shows promise for treatment-resistant youth with ASD accompanied by hyperactivity, impulsivity, aggression and self injury.