Revisiting Lithium: Utility for Behavioral Stabilization in Adolescents and Adults with Autism Spectrum Disorder.

Objectives: To examine the efficacy of lithium as a mood stabilizer for patients with autism spectrum disorder (ASD). Experimental Design: A retrospective chart review was performed that examined the use of both extended and immediate release lithium carbonate in patients with ASD that were treated at a single clinical center (CNNH NeuroHealth). Clinical Global Impression (CGI) scales were used to quantify baseline severity of ASD and mood symptoms as well as improvement after treatment with lithium carbonate. Principle Observations: Our retrospective chart review found that 73.7% (n = 14) of patients with ASD and concomitant maladaptive behaviors experienced "improvement" (CGI-I rating ≤ 3) with the addition of lithium to their treatment regimen. Those with comorbid "ADHD" phenotype were most predictive of an efficacious response (p = 0.038, Odds Ratio 12.2). Conclusions: Lithium carbonate is a viable, efficacious and well tolerated alternative to various neuroleptics and other psychotropic medications for use as a mood stabilizer for patients with ASD.