ORCID
- Lance V. Watkins: 0000-0002-0447-5906
- Rohit Shankar: 0000-0002-1183-6933
Abstract
Introduction: Autism, like other neurodevelopmental disorders (NDDs), has a strong association with epilepsy. There are known common genetic pathways in both autism and epilepsy. There are also specific genetic syndromes associated with both complex epilepsy and the autism phenotype. Areas covered: This review explores the evidence for common genetic etiologies and pathophysiological pathways in relation to both epilepsy and autism. Autism with comorbid epilepsy are associated with a high prevalence of medical and psychiatric comorbidities. This paper discusses how this influences assessment, treatment, and outcomes. The evidence for the treatment of specific seizure types in the context of NDDs is also examined alongside clinical commentary. Expert opinion: Despite the strong association, there is a limited evidence base to support the efficacy and tolerability of anti-seizure medications specifically in autism, with no Level 1 evidence or National Guidance available. Autism and epilepsy should be approached under a NDD model with cautious introduction and titration of anti-seizure medication. Alongside this, there is evidence to support a move toward precision medicine in specific genetic syndromes such as Tuberous Sclerosis Complex and other genetic seizure disorders. The first-line treatments that should be considered for focal seizures include carbamazepine, lamotrigine, and levetiracetam.
DOI
10.1080/14656566.2022.2055461
Publication Date
2022-01-01
Publication Title
Expert Opinion on Pharmacotherapy
Volume
23
Issue
7
ISSN
1465-6566
Embargo Period
2023-12-23
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
First Page
841
Last Page
851
Recommended Citation
Shankar, R., Watkins, L., & O’Dwyer, M. (2022) 'A review of the pharmacotherapeutic considerations for managing epilepsy in people with autism', Expert Opinion on Pharmacotherapy, 23(7), pp. 841-851. Available at: https://doi.org/10.1080/14656566.2022.2055461