Faculty Bibliography

Videotapes of autistic children with stereotypies and/or neuroleptic-related dyskinesias were shown to three experienced raters blind to the children's medication treatment status and history, if any, of neuroleptic exposure. Upon observation of the videotapes, stereotypies and neuroleptic-related dyskinesias were not well differentiated from each other. These results emphasize the importance of assessing and documenting baseline abnormal movements before patients receive neuroleptic therapy. Meticulous baseline evaluation, integral to all patient care, is of particular concern in treating patient populations that often show abnormal movements unrelated to neuroleptic exposure. Such movements can be mistaken clinically for neuroleptic-related dyskinesias and, in the absence of baseline data for comparison, can be misdiagnosed as such

The safety and efficacy of naltrexone was explored in an open acute dose range tolerance trial in 10 hospitalized autistic children, ages 3.42 to 6.50 years (mean, 5.04). Naltrexone was given in ascending doses: 0.5, 1.0, and 2.0 mg/kg/day. Behavioral side effects were observed as early as 1/2 hour after dosing. Ratings on the Children's Psychiatric Rating Scale showed that withdrawal was reduced across all three dose levels; administration of 0.5 mg/kg/day dose resulted in increased verbal production; and the 2.0 mg/kg/day dose resulted in reduction of sterotypies. Mild sedation of brief duration was the only side effect. Electrocardiogram, liver function tests, and all other laboratory studies remained unchanged throughout the study. These preliminary findings require replication in a larger sample of patients under double-blind and placebo controlled condition