An overview of pharmacotherapy in the management of children diagnosed with autism spectrum disorder at a public hospital in KwaZulu-Natal, South Africa

AbstractBackground The pharmacological management of Autism Spectrum Disorder (ASD) remains a challenge due to limited effective treatment options, the Food and Drug Administration's (FDA) approval of only two drugs, and the absence of drugs that can cure the core symptoms. In South Africa, little is known about the role of pharmacotherapy in the management of children diagnosed with ASD. This study presents an overview of prescribing patterns and provides insight into the current management practice for the core symptoms and comorbidities of ASD in children. Method A quantitative retrospective study was conducted at a public hospital in Kwa-Zulu Natal, South Africa by reviewing patient files of children diagnosed with ASD and meeting the inclusion criteria for the study. A descriptive analysis of data was done to identify treatment trends and patient therapeutic outcomes. Results A total of 181 children met the inclusion criteria of the study. Risperidone was the most frequently prescribed drug (88%) for the management of comorbidities and/or core symptoms of ASD. Attention deficit hyperactivity disorder (54%), irritability or aggression (25%), and sleep dysregulation (22%) were frequent ASD comorbidities that warranted pharmacotherapy. Drugs prescribed to manage ASD comorbidities included methylphenidate, melatonin, sodium valproate, risperidone, oxybutynin, carbamazepine, and others. Except for risperidone, there were no additional drugs that targeted the core symptoms of ASD. Non-pharmacological therapies were often used collaboratively with medication to manage ASD symptoms. The use of psychotropic drug combinations was influenced by the age and gender of a child. In 41% of patients, there were improvements in their symptoms (comorbidities and/or core symptoms) which indicated a positive response to the treatment plan. Conclusion Drugs played a prominent role in managing the comorbidities of ASD, however, pharmaco-therapeutic options for the management of ASD core symptoms are limited. As the availability and use of additional effective drugs (including vitamin, mineral, and dietary supplements) for the management of ASD increases, improved therapeutic outcomes for children with ASD in South Africa could be achievable.