A major systemic review by Bahrain-based doctors is highlighting a shift in the way autism spectrum disorder (ASD) is being medically approached, with growing emphasis on precision medicine and individualised care in the absence of a definitive treatment ... with food for thought over a trailblazing new finding.
The findings suggest that future therapies may be tailored to each child’s unique biological profile, moving away from a one-size-fits-all approach and towards more targeted interventions.
Published this month in the World Journal of Clinical Paediatrics, the review was led by doctors from the University Hospital, Arabian Gulf University and The Royal College of Surgeons in Ireland-Bahrain, as well as by other medical professionals in Egypt.
The team evaluated evidence from trials and studies involving children and adolescents aged 18 and younger, examining both established and emerging treatments for ASD.
While the review found that no medication currently treats autism’s core social and communication difficulties, several therapies were shown to help manage associated symptoms such as irritability, aggression, hyperactivity and attention difficulties.
Following PRISMA guidelines, the researchers reviewed five major categories of interventions: atypical antipsychotics, stimulants, selective serotonin reuptake inhibitors (SSRIs), metabolic and nutritional therapies, and microbiota-gut-brain axis treatments.
“Perhaps the most important message from this review is that autism treatment is moving towards precision medicine,” University Hospital, Arabian Gulf University paediatric consultant Professor Mohammed Elbeltagi, one of the study’s authors, told the GDN.
“Rather than giving the same treatment to every child, researchers are increasingly seeking biological markers to predict which children are most likely to benefit from a particular therapy.”
Among the most effective medications currently available are risperidone and aripiprazole, which have been approved to reduce severe irritability, aggression, self-injury and tantrums in children with autism.
“Studies consistently show that both medications can substantially improve challenging behaviours and help families cope with difficult situations,” Dr Elbeltagi said.
However, he cautioned that these benefits come with potential side effects. Risperidone has been linked to significant weight gain and metabolic complications, while aripiprazole can cause drowsiness and increased appetite, making careful monitoring essential.
The review also examined medications commonly used to treat attention-deficit/hyperactivity disorder (ADHD), which frequently occurs alongside autism. “Drugs such as methylphenidate and atomoxetine can improve attention and reduce hyperactivity in affected children, although they do not appear to address autism’s core features,” Dr Elbeltagi said.
One of the most promising areas of research identified in the review involves the connection between the gut and the brain.
“Scientists have discovered that many children with autism experience gastrointestinal problems and have differences in their gut microbiome – the collection of microorganisms living in the digestive tract,” Dr Elbeltagi explained.
“Early research suggests that microbiota-based therapies, including microbiota transfer therapy and certain microbiome-targeted approaches, may improve both digestive symptoms and some behavioural outcomes in selected children.
“While the evidence is still developing, these findings have opened a promising new direction for autism research,” he said.
Researchers are also exploring treatments that target specific biological pathways. “High-dose folinic acid has shown benefits for children with certain immune-related markers, while bumetanide may be effective in subgroups of children with particular brain activity patterns,” he said.
“These discoveries suggest that autism is not a single condition but rather a collection of related conditions with different underlying biological mechanisms.”
Interest is also growing in cannabidiol (CBD)-based therapies, he added.
Looking ahead, the authors believe treatment decisions may increasingly be guided by genetic testing, metabolic profiles, brain imaging, immune markers, or microbiome analysis.
“The goal is no longer simply to manage symptoms but to understand each child’s unique biology and provide the treatment most likely to help that specific child thrive,” Dr Elbeltagi said. “As research continues, personalised medicine may transform the way autism is treated and improve the lives of countless children and families around the world.”
According to the latest statistics published by the GDN, 2,122 individuals with autism are registered with Bahrain’s Social Development Ministry.
julia@gdnmedia.bh
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