Efficacy and Safety of Alpha-2 Agonists in Autism Spectrum Disorder: A Systematic Review

Adv Ther. 2024 Nov;41(11):4299-4311. doi: 10.1007/s12325-024-02980-0. Epub 2024 Sep 13.

Abstract

Background: This analysis is a systematic literature review assessing efficacy and adverse effects of three alpha-2 agonists for the symptomatic management of autism spectrum disorder (ASD).

Methods: The present investigation involved an extensive systematic search for eligible studies in PubMed, Embase, Cochrane Library, and Google Scholar. Nine studies, collectively incorporating 226 patients, were assessed.

Results: The results demonstrated promising indications for use of alpha-2 agonists in the symptomatic management of autism spectrum disorders, including improvement of hyperactivity, impulsivity, attention deficit symptoms, irritability, and stereotypies in many of the participants studied.

Conclusion: The present investigation encourages physicians to consider treatment outcomes of clonidine, guanfacine, and lofexidine to determine the most effective management of ASD-related symptoms and to minimize adverse effects. However, our review cannot provide definitive treatment protocols related to various study limitations.

Keywords: Alpha-2 agonist; Autism spectrum disorder; Clonidine; Guanfacine; Lofexidine; Neurodevelopmental disorder; Pervasive developmental disorder.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Adrenergic alpha-2 Receptor Agonists* / adverse effects
  • Adrenergic alpha-2 Receptor Agonists* / therapeutic use
  • Attention Deficit Disorder with Hyperactivity / drug therapy
  • Autism Spectrum Disorder* / drug therapy
  • Child
  • Clonidine* / adverse effects
  • Clonidine* / therapeutic use
  • Guanfacine* / adverse effects
  • Guanfacine* / therapeutic use
  • Humans
  • Treatment Outcome

Substances

  • Adrenergic alpha-2 Receptor Agonists
  • Clonidine
  • Guanfacine