Antiepileptic drugs: Affective use in autism spectrum disorders

Antiepileptic drugs are widely administered to individuals with autistic sp ectrum disorders. There are several reasons for the use of antiepileptic dr ugs in autistic spectrum disorders, including the high incidence of epileps y in these individuals, the anecdotal reports suggesting an improvement of communication and behavior in autistic subjects with epileptic discharges, and the increased awareness that some disruptive behaviors may be manifesta tions of an associated affective disorder. In this study, data on the curre nt use of antiepileptic drugs in the treatment of autism, and on the associ ation of affective disorders with epilepsy and autism, are reviewed. The ev idence supporting the hypothesis that there may be a subgroup of autistic c hildren with epilepsy and affective disorders that preferentially respond t o antiepileptic drugs is still very preliminary, and further investigations with double-blind controlled studies are needed. Although the role of anti epileptic drugs at the present time is not established, there is evidence t hat autism, epilepsy, and affective disorders commonly co-occur, and that t hey may share a common neurochemical substrate, which is the common target of the psychotropic mechanism of action of different antiepileptic drugs. ( C) 2001 by Elsevier Science Inc. All rights reserved.