olanzapine and Asperger-Syndrome

Topics: Adaptation, Psychological; Asperger Syndrome; Benzodiazepines; Causality; Central Nervous System Depressants; Child; Child Behavior; Diagnosis, Differential; Early Diagnosis; Fluvoxamine; Humans; Interpersonal Relations; Melatonin; Nurse Practitioners; Nursing Assessment; Olanzapine; Prevalence; Primary Health Care; Prognosis; Psychological Tests; Psychology, Child; Risperidone; Serotonin Agents; Social Behavior; United States

Topics: Adolescent; Antipsychotic Agents; Asperger Syndrome; Benzodiazepines; Child; Female; Humans; Male; Olanzapine; Psychiatric Status Rating Scales; Treatment Outcome; Weight Gain

Atypical antipsychotics have been shown to improve disruptive and repetitive behaviors in pervasive developmental disorders (PDDs), but they require assessment of potential side effects. This is the first placebo-controlled trial of olanzapine in the treatment of children and adolescents with PDD. Eleven patients with a diagnosis of either autism, Asperger's syndrome, or PDD not otherwise specified (PDD-NOS) and aged 6-14 years were randomized into an 8-week double-blind, placebo-controlled, parallel treatment study with olanzapine. There was a significant linear trend x group interaction on the Clinical Global Impressions- Improvement (CGI-I) and 50% on olanzapine versus 20% on placebo were responders. Olanzapine was associated with significant weight gain (7.5 +/- 4.8 lbs vs. 1.5 +/- 1.5 lbs on placebo). Olanzapine may be a promising treatment for improving global functioning of PDDs, but the risk of significant weight gain remains a concern. Additional studies are needed to determine the efficacy and safety of olanzapine in the treatment of children with PDD.

Topics: Adolescent; Antipsychotic Agents; Asperger Syndrome; Autistic Disorder; Benzodiazepines; Child; Child Development Disorders, Pervasive; Double-Blind Method; Female; Humans; Male; Olanzapine; Pilot Projects; Treatment Outcome; Weight Gain

Priapism is a potentially painful and prolonged erection that occurs in the absence of any stimulation. Olanzapine has been reported to induce priapism in several adult cases with schizophrenia and/or mood disorders but very rarely reported in children.. 9-year-old male with Asperger's Syndrome (AS) referred to our clinic with the complaints of inattention, hyperactivity and impulsivity. He was diagnosed with attention deficit hyperactivity disorder (ADHD) and given methylphenidate treatment which ameliorated his ADHD symptoms. He started to have severe loss of appetite after methylphenidate treatment so olanzapine 2.5 mg/day was added to cope with severe inappetence. However he experienced priapism after olanzapine and priapism resolved after ceasing the drug. His mother restarted olanzapine because he benefited from olanzapine. But the same episodes occurred soon after olanzapine again and his mother had to stop the medication.. Because atypical antipsychotics are now widely used in children, unusual side effects such as priapism should be taken into consideration for the differential diagnosis.

Topics: Antipsychotic Agents; Asperger Syndrome; Attention Deficit Disorder with Hyperactivity; Benzodiazepines; Child; Humans; Male; Olanzapine; Priapism