College of Psychiatric and Neurologic Pharmacists

Pervasive developmental disorders (PDDs) are neuropsychiatric disorders characterized by social and communication impairments, as well as repetitive interests and activities.  The five PDD include Autistic Disorder, Asperger’s Disorders, Rett’s Disorder, Childhood Disintegrative Disorder, and PDD Not Otherwise Specified. Children and adolescents diagnosed with PDDs often suffer from a number of target symptoms that require pharmacologic treatment.  Symptoms frequently include hyperactivity and inattention, ritualistic and repetitive behavior, and irritability (aggression, self-injury, tantrums).  The purpose of this presentation is to review the diagnosis and treatment of PDDs.

Methods: Diagnosis of PDDs based on DSM-IV-TR criteria is discussed.  Evidence to date is presented on the pharmacotherapy of PDDs.  Emphasis is placed on randomized, controlled trials, with an effort to address efficacy as well as common adverse effects via a case-based approach.  Components of a comprehensive treatment plan are reviewed.

Results: The diagnosis of PDDs requires careful attention to the developmental history.  The pharmacotherapy of PDDs is based on the identification of target symptoms.  Research focused on the treatment of hyperactivity and inattention has included psychostimulants, atomoxetine, and alpha₂ adrenergic agonists.  Selective serotonin reuptake inhibitors have been studied for targeting interfering repetitive behavior, with recent studies finding fluoxetine and citalopram ineffective.  Atypical antipsychotics, such as risperidone, have been found to be effective for irritability in PDDs.  Tolerability profiles vary among agents, necessitating ongoing monitoring.  A comprehensive treatment plan is multimodal, and often includes pharmacologic management, behavior therapy, speech therapy, and occupational therapy, among others.

Conclusions:  Diagnosis of PDDs involves a detailed diagnostic assessment. Recent advances in the pharmacotherapy of target symptoms in youth with PDDs continue to inform practice.  Development of an individualized comprehensive treatment plan is recommended.

1. Distinguish between the signs and symptoms of autism and the other pervasive developmental disorders.
2. Compare evidence and non-evidence based pharmacologic intervention for autism, with a focus on target symptoms, efficacy, and safety.
3. Formulate a comprehensive treatment plan for a patient with autism disorder, including both pharmacological and non-pharmacological treatment.

Activity Dates: 04/18/2010 - 04/18/2013
ACPE Contact Hours: 1.0
ACPE Number: 0284-0000-10-002-H01-P (Knowledge)
Nursing Credit Reminder: Note that ACPE and ACCME credit is accepted for certification renewal.

This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.

Participants in this course must complete an examination and achieve a score of 60% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the medication therapy management of psychiatric and/or neurological patients, we invite you to participate in this online course.

This programming was supported in part by grants from Janssen, Ortho-McNeil Janssen Scientific Affairs, LLC, supported by an educational grant from Janssen, Division of Ortho-McNeil Janssen Pharmaceuticals, Inc. administered by Ortho-McNeil Janssen Scientific Affairs, LLC. and Lilly USA, LLC.