Low Doses of Venlafaxine in a Young Man with ASD and Behavioral Disorders: A Case Report

Objective: No specific pharmacological approach to behavioral disorders in patients with severe intellectual disabilities associated with autism spectrum disorder (ASD) exists. Neuroleptics are known to be epileptogenic, and benzodiazepines have an adverse effect on their already limited cognitive capabilities. The possibility of managing behavioral disorders in persons with ASD via antidepressants, namely venlafaxine, could provide a substantial improvement in their overall condition and quality of life and could contribute to the definition of a specific pharmacological indication. Method: The present case report describes the effect of venlafaxine at low doses (18.75 mg/j) in an 18-year-old patient with ASD, severe intellectual disabilities and behavioral disorders. Based on the records kept by the patient’s mother and our clinical observations, we describe the evolution of this young man from birth to 18 years of age. Results: Since the introduction of venlafaxine, the patient’s behavioral troubles improved greatly. There was major progress in attention, and the patient became calm and appeased, able to obey to simple commands and to control his hunger. He became notably less aggressive with himself and others, he became better at managing relationships, and he was more conciliatory and accepting of being touched. Today, this young man continues his apprenticeship of everyday life. He is quieter and has learned simple actions performed in an everyday context. He can smile and lend attention to the environment and to other persons. Some problems remain unresolved, such as movement and double incontinence. Conclusion: The improvement of our patient is challenging behavior shows encouraging progress in the treatment of ASD’s typical behavior disorders. The use of antidepressants represents a substantial improvement in the care of patients with intellectual disabilities, ASD and severe behavioral disorders. These results are evidence of a new pharmaceutical strategy for the improvement of the quality of life of these patients.