BACKGROUND: Patients with autism spectrum disorder (ASD) can present with momentary behaviors of acute agitation or challenging behaviors like oppositional activities, along with more severe behaviors such as dangerous self-injuries or aggressions. Often referred to as crisis behaviors, these are hard to predict and can be difficult to manage.

OBJECTIVES: To outline the burden of the disease, current standard of care, and unmet needs for the treatment of agitation in autism

METHODS: Secondary literature search was limited to English publications over the last 10 years

RESULTS: Agitation is associated with negative outcomes for children with ASD and their caregivers, including decreased quality of life. A 2011 study in the US demonstrated that 56% of individuals with ASD (n=1,380) directed aggression toward caregivers and 32% directed aggression toward non-caregivers. Another study that among 299 hospitalized autism patients, 37 of them had one or more episodes of agitation and the per hospitalization number of episodes of agitation ranged from 1 – 32. The National Institute for Healthcare and Excellence (NICE) has established a guideline that recommends an initial psychosocial approach followed by use of antipsychotics, the former failing. Risperidone and Aripiprazole are the only 2 drugs that are approved by the USFDA for use in the treatment of agitation in autism but are associated with various side effects on long-term use. Some pipeline therapies in Phases II-III of clinical trials were identified which could potentially change the treatment landscape.

CONCLUSIONS: Agitation in autism is a cardinal concern and there is a need for research to identify the epidemiological patterns of the disease, primarily since children in their prime are most affected and is associated with a significant burden. Additionally, there is a need for more therapeutic guidelines and alternatives for this segment of patients to improve their quality of life.