Psychiatry and Clinical Psychopharmacology (Oct 2018)

The utility of psychotropic drugs on patients with Fetal Alcohol Spectrum Disorder (FASD): a systematic review

  • Mansfield Mela,
  • Udoka Okpalauwaekwe,
  • Tara Anderson,
  • Jamie Eng,
  • Shawn Nomani,
  • Adekunle Ahmed,
  • Alasdair M. Barr

DOI
https://doi.org/10.1080/24750573.2018.1458429
Journal volume & issue
Vol. 28, no. 4
pp. 436 – 445

Abstract

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BACKGROUND: Treatment of the complications arising from Prenatal Alcohol Exposure (PAE) has largely been focused on psychosocial and environmental approaches. Research on the use of medications, especially psychotropic medications, has lagged behind. OBJECTIVES: This systematic review sought to investigate psychotropic medication related findings and outcomes in those diagnosed with Fetal Alcohol Spectrum Disorder (FASD). METHODS: Comprehensive searches were conducted in seven major databases (Medline/PubMed, Scopus, Web of Knowledge, Embase, PsycINFO, Cochrane Library, and PsycARTICLES) up to February 2017. Key search terms with synonyms were mapped on these databases. There were no timeline restrictions and no grey literature searches. Two reviewers independently assessed 25 studies that met the inclusion criteria. Most studies were reviews of treatment and retrospective case series. RESULTS: Two crossover randomized trials were reported, and the findings were not amenable to meta-analysis. Several conditions (depression, agitation, seizures, and outburst) combined with the most frequent presentation, ADHD, to represent the rationale for prescribing psychotropic medications. Second-generation antipsychotics were found to improve social skills, but the paucity of data limited the extent of clinical guidance necessary for the field. CONCLUSIONS: The systematic review showed that there are some clinical evidence displaying the validity of psychopharmacological interventions in people with FASD, which varies across the spectrum of disease severity, age, and gender. There is a need for more clinical evidence-based studies in addition to clinical expert opinions to substantiate an optimal ground for individualized management of FASD. The study protocol for this review was registered in PROSPERO with registration number CRD42016045703.

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