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Antiepileptic Medications in Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

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Abstract

Electroencephalogram-recorded epileptiform activity is common in children with autism spectrum disorder (ASD), even without clinical seizures. A systematic literature search identified 7 randomized, placebo-controlled trials of antiepileptic drugs (AEDs) in ASD (total n = 171), including three of valproate, and one each of lamotrigine, levetiracetam, and topiramate. Meta-analysis revealed no significant difference between medication and placebo in four studies targeting irritability/agitation and three studies investigating global improvement, although limitations include lack of power and different medications with diverse actions. Across all seven studies, there was no significant difference in discontinuation rate between two groups. AEDs do not appear to have a large effect size to treat behavioral symptoms in ASD, but further research is needed, particularly in the subgroup of patients with epileptiform abnormalities.

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Acknowledgments

Dr. Kishi has received speaker’s honoraria from Abbott, Astellas, Daiichi Sankyo, Dainippon Sumitomo, Eli Lilly, GlaxoSmithKline, Yoshitomi, Otsuka, Meiji, Shionogi, Tanabe-Mitsubishi, Novartis and Pfizer. Dr. Veenstra-VanderWeele has received research funding from Seaside Therapeutics, Novartis, Roche, Forest, and SynapDx. He has served on an advisory board for Novartis. Dr. Hollander has received research funding from Abbott, UCB Pharma, Roche, Forest. He has served on advisory boards for Abbott, Roche, Neuropharm and Coronado. Dr. Hirota has nothing to disclose.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry, Vanderbilt University Medical Center, 1601 23rd Avenue South 3102 VPH, Nashville, TN, 37212, USA

    Tomoya Hirota & Jeremy Veenstra-VanderWeele

  2. Department of Psychiatry, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA

    Eric Hollander

  3. Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Taro Kishi

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  1. Tomoya Hirota
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  2. Jeremy Veenstra-VanderWeele
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  3. Eric Hollander
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  4. Taro Kishi
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Correspondence to Tomoya Hirota.

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Hirota, T., Veenstra-VanderWeele, J., Hollander, E. et al. Antiepileptic Medications in Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. J Autism Dev Disord 44, 948–957 (2014). https://doi.org/10.1007/s10803-013-1952-2

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  • DOI: https://doi.org/10.1007/s10803-013-1952-2

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