Autistic children

The dorsal and ventral hippocampus is involved in the formation of social memory (van Wimersma Greidanus and Maigret, 1996). Neonatal ablations of hippocampal regions can lead to decreased and abnormal social behavior in rhesus monkeys that is reminiscent of severe neuropsychiatric disorders in humans such as autism and schizophrenia (Bachevalier et ah, 1999). These monkeys are often withdrawn socially and will develop locomotoric stereotypies a pattern similar to that found in autistic children. 

Brambilla, F, Guareschi-Cazzullo, A., Tacchini, C., Musetti, C., Pa-nerai, A.E., and Sacerdote, P. (1997) Beta-endorphin and chole-cystokinin 8 concentrations in peripheral hlood mononuclear cells of autistic children. Neuropsychobiology 35 1—... 

Hoshino, Y., Yamamoto, T., Kaneko, M., Tachibana, R., Wantabe, M., Ono, Y., and Kumashiro, H. (1984) Blood serotonin and free tryptophan concentration in autistic children. Neuropsychobiology 11 22-27. 

Modahl, C., Green, L., Fein, D., Morris, M., Waterhouse, L., Fein-stein, C., and Levin, H. (1998) Plasma oxytocin levels in autistic children. Biol Psychiatry 43 270-277. 

Casaer, R, Walleghem, D., Vandenbussche, L, Huang, M.-L., and DeSmedt, G. (1994) Pharmacokinetics and safety of risperidone in autistic children [abstract]. Pediatr Neurol 11 89. 

Willemsen-Swinkels et al., 1996a). This further seems to detract from the clinical utility in prescribing naltrexone to treat hyperactivity in subjects with autism. Although an expert has advocated that all autistic children should have a trial with naltrexone, this opinion has not met consensus within the professional community (Campbell and Harris, 1996). 

N. M., and Ernst, M. (1993) Naltrexone in autistic children— behavioral symptoms and attentional learning./ Am Acad Child Adolesc Psychiatry 32 1283-1291. 

Campbell, M. and Harris, J.C. (1996) Resolved autistic children should have a trial of naltrexone. / Am Acad Child Adolesc Psychiatry 35 246-249. 

Campbell, M., Overall, J.E., Small, A.M., Sokol, M.S., Spencer, E.S., Adams, P., Foltz, R.L., Monti, K.M., Perry, R., Nobler, M., and Roberts, E. (1989) Naltrexone In autistic children an acute open dose range tolerance trial. / Am Acad Child Adolesc Psychiatry 28 200-206. 

Herman, B.H., Hammock, M.K., Arthur-Smith, A., Kuehl, K., and Appelgate, K. (1989) Effects of acute administration of naltrexone on cardiovascular function, body temperature, body weight and serum concentrations of liver enzymes in autistic children. Dev Pharmacol Ther 12 118—27. 

Kolmen, B.K., Feldman, H.M., Handen, B.L., and Janosky, J.E. (1997) Naltrexone in young autistic children replication study and learning measures./ Am Acad Child Adolesc Psychiatry 36 1570-1578. 

Willemsen-Swinkels, S.H.N., Buitelaar, J.K., and Van Engeland, H. (1996a) The effects of chronic naltrexone treatment in young autistic children a double-blind placebo-controlled crossover study. Biol Psychiatry 39 1023—1031. 

Campbell and co-workers conducted several controlled studies of haloperidol in autistic children (Campbell et al., 1978 Cohen et al., 1980 Anderson et al., 1984, 1989). Haloperidol, in doses of 1 to 2 mg/ day, was found to be more effective than placebo for withdrawal, stereotypy, hyperactivity, affective lability, anger, and temper outbursts. Acute dystonic reactions and withdrawal and tardive dyskinesias were not infrequent, however. 

In Kanner s 1943 landmark description of 11 autistic children, the repetitive nature of behavior, speech, and modes of social interaction were designated as core clinical elements of the syndrome (Kanner, 1943). Verbal and motor rituals, obsessive questioning, a rigid adherence to routine, a preoccupation with details, and an anxiously obsessive desire for the maintenance of sameness and completeness were all noted. These phenomena remain as core elements in the diagnostic criteria for autistic disorder in DSM-IV. 

The pharmacological management of motor hyperactivity and impaired attentional mechanisms in individuals with PDDs has proven particularly challenging for clinicians and researchers. These symptoms are most prominent in younger autistic children. Thus, these symptoms are largely present during a time when educational programming and interventions are most critical. 

Lamotrigine is an anticonvulsant drug that attenuates some forms of cortical glutamate release via inhibition of sodium, calcium, and potassium channels. An open-label case series (Uvebrant and Bauziene, 1994) and a case report (Davanzo and King, 1996) described improvement in autistic symptoms and self-injurious behavior, irritability, disturbed sleep, and social impairment in autistic children and an 18-year-old female with profound mental retardation, respectively, who were treated for epilepsy. 

Cohen, I.L., Campbell, M., Posner, D., Small, A.D., Triebel, D., and Anderson, L.T. (1980) Behavioral effects of haloperidol in young autistic children an objective analysis using a within-subjects reversal design. / Am Acad Child Adolesc Psychiatry 19 665-677. 

Sanchez, L.E., Campbell, M., Small, A.M., Cueva, J.E., Armenteros, J.L., and Adams, P.B. (1996) A pilot study of clomipramine in young autistic children. J Am Acad Child Adolesc Psychiatry 35 537-544. 

Haloperidol-related dyskinesias and pre- and perinatal complications in autistic children. PsychopharmacolBull31 363-369. 

Campbell, M., Anderson, L., Meier, M., Cohen, I., Small, A., Samit, C., and Sachar, E. (1978) A comparison of haloperidol and behavior therapy and their interaction in autistic children. / Am Acad Child Adolesc Psychiatry 17 640-655. 

Locascio, J.J., Malone, R.P., Small, A.M. et al. (1991) Factors related to haloperidol response and dyskinesias in autistic children. Psychopharmacol Bull 27 119-126. 

Perry R, Campbell M, Adams P, et al. Long term efficacy of haloperidol in autistic children continuous versus discontinuous drug administration. J Am Acad Child Adolesc Psychiatry 1989 28 87-92. 

Campbell M, Armentereos JL, Malone RP, et al. Neuroleptic related dyskinesias in autistic children a prospective, longitudinal study. J Am Acad Child Adolesc Psychiatry 1997 36 835-843. Frazier JA, Giedd JN, Kaysen D, et al. Childhood onset schizophrenia brain MRI rescan after 2 years of clozapine maintenance treatment. Am J Psychiatry 1996 153 564-566. 

---