Evidence-Based Reviews

Pharmacologic management of autism spectrum disorder: A review of 7 studies

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References

6. Mazahery H, Conlon CA, Beck KL, et al. A randomised controlled trial of vitamin D and omega-3 long chain polyunsaturated fatty acids in the treatment of irritability and hyperactivity among children with autism spectrum disorder. J Steroid Biochem Mol Biol. 2019;187:9-16.

Irritability and hyperactivity are common comorbid symptoms in children with ASD and have been linked to lower quality of life, poor adaptive functioning, and lower responsiveness to treatments when compared to children without comorbid problem behaviors. Mazahery et al9 evaluated the efficacy of vitamin D, omega-3 long-chain polyunsaturated fatty acids (LCPUFA), or both on irritability and hyperactivity.


Study design

  • In a 1-year, double-blind, placebo-controlled trial, 73 children age 2.5 to 8 years with ASD were randomly assigned to receive placebo; vitamin D, 2000 IU/d (VID); omega-3 LCPUFA, 722 mg/d (OM); or both in the aforementioned doses.
  • The primary outcome was reduction in the Aberrant Behavior Checklist in the domains of irritability and hyperactivity. Caregivers also completed weekly surveys regarding adverse events, compliance, and utilization of behavioral therapies.
  • Of 111 children enrolled, 73 completed the 12 months of treatment.

Outcomes

  • Children who received OM and VID had a greater reduction in irritability than those who received placebo (P = .001 and P = .01, respectively).
  • Children who received VID also had a reduction in irritability (P = .047).
  • An explanatory analysis revealed that OM also reduced lethargy (based on the Aberrant Behavior Checklist) more significantly than placebo (P = .02 adjusted for covariates).

Conclusion

  • Treatment with vitamin D, 2000 IU/d, reduced irritability and hyperactivity.
  • Treatment with omega-3 LCPUFA, 722 mg/d, reduced hyperactivity and lethargy.

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