Pharmacotherapy for severe aggression in a child with autism: "open label"evaluation of multiple medications on response frequency and intensity of behavioral intervention

Many persons who have developmental disabilities and challenging behaviors are treated with multiple medications combined with nonpharmacological appr oaches. However, the comparative effects from pharmacotherapy frequently ar e not assessed empirically, do not include corollary behavioral measures, a nd are not evaluated in the long term. The present single-case study incorp orated behavioral assessment methodology in an "open label" evaluation of a nticonvulsant (clonazepam), beta-blocking (propanolol), and antidepressant (sertraline and clornipramine) medications on severe aggression in a child with autism. Clinically significant reductions in aggressive behavior were attained with the administration of clornipramine and the reductive effects from the medication persisted for 1.7 years. In addition, clornipramine wa s associated with the elimination of crisis intervention procedures that ha d been required to manage the child's aggression. These findings add to the clinical literature describing effective treatment of serious behavior dis orders in persons with developmental disabilities using antidepressant medi cation. (C) 2001 Elsevier Science Ltd. All rights reserved.