RT Journal Article
T1 Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response
A1 Salazar de Pablo, Gonzalo
A1 Moreno Ruiz, María del Carmen
A1 Arango López, Celso
A1 Parellada Redondo, María José
AB Objective: Emotional dysregulation and irritability are common in individuals with autism spectrum disorder (ASD). We conducted the first meta-analysis assessing the efficacy of a broad range of pharmacological interventions for emotional dysregulation and irritability in ASD and predictors of response.Method: Following a preregistered protocol (PROSPERO: CRD42021235779), we systematically searched multiple databases until January 1, 2021. We included placebo-controlled randomized controlled trials (RCTs) and evaluated the efficacy of pharmacological interventions and predictors of response for emotional dysregulation and irritability. We assessed heterogeneity using Q statistics and publication bias. We conducted subanalyses and meta-regressions to identify predictors of response. The primary effect size was the standardized mean difference. Quality of studies was assessed using the Cochrane Risk of Bias Tool (RoB2).Results: A total of 2,856 individuals with ASD in 45 studies were included, among which 26.7% of RCTs had a high risk of bias. Compared to placebo, antipsychotics (standardized mean difference = 1.028, 95% CI = 0.824-1.232) and medications used to treat attention-deficit/hyperactivity disorder (ADHD) (0.471, 0.061-0.881) were significantly better than placebo in improving emotional dysregulation and irritability, whereas evidence of efficacy was not found for other drug classes (p > .05). Within individual medications, evidence of efficacy was found for aripiprazole (1.179, 0.838-1.520) and risperidone (1.074, 0.818-1.331). Increased rates of comorbid epilepsy (β = -0.049, p = .026) were associated with a lower efficacy.Conclusion: Some pharmacological interventions (particularly risperidone and aripiprazole) have proved efficacy for short-term treatment of emotional dysregulation and irritability in ASD and should be considered within a multimodal treatment plan, taking into account also the tolerability profile and families' preferences.
PB Elsevier
SN 0890-8567
YR 2023
FD 2023-02-01
LK https://hdl.handle.net/20.500.14352/130735
UL https://hdl.handle.net/20.500.14352/130735
LA eng
NO Salazar de Pablo, G., Pastor Jordá, C., Vaquerizo-Serrano, J., Moreno, C., Cabras, A., Arango, C., Hernández, P., Veenstra-VanderWeele, J., Simonoff, E., Fusar-Poli, P., Santosh, P., Cortese, S., & Parellada, M. (2023). Systematic Review and Meta-analysis: Efficacy of Pharmacological Interventions for Irritability and Emotional Dysregulation in Autism Spectrum Disorder and Predictors of Response. Journal of the American Academy of Child and Adolescent Psychiatry, 62(2), 151–168. https://doi.org/10.1016/j.jaac.2022.03.033
DS Docta Complutense
RD 21 mar 2026