Bumetanide in Children and Adolescents with Autism ‎Spectrum Disorder

Introduction: Autism Spectrum Disorder (ASD) is characterized by several impairments in communications and social interactions as well as restricted interests or stereotyped behaviors. Interventions applied for this disorder are based on multi-modal approaches, including pharmacotherapy. No cure or medication has been introduced so far; therefore, there were studies investigating several drugs for treating individuals with ASD. One of the recent medications introduced for this purpose was Bumetanide. Accordingly, the purpose of the present article was to review the efficacy of this drug on the core symptoms of ASD and its potential side effects. Method: All papers reported pharmacokinetics, pharmacodynamics, efficacy, and adverse effects of Bumetanide on animal models and humans with ASD. The papers were reviewed based on the main databases of PubMed, Web of Science, and Scopus. Results: The findings revealed that cortical neurons have high chloride ion (Cl−)i and excitatory actions of Gamma Aminobutyric Acid (GABA) in the valproic acid animal model with ASD and mice with fragile X syndrome. Bumetanide which has firstly been introduced as a diuretic is also a high affinity-specific Na+-K+-Cl− cotransporter (NKCC1) antagonist that can reduce (Cl−). The results also indicated that Bumetanide could attenuate behavioral features of autism in both animal and human models. Moreover, the studies showed that such a medication could activate fusiform face area in individuals with ASD while viewing emotional faces. Also, recent findings suggested that a dose of 1 mg of this drug taken twice daily might be the best compromise between safety and efficacy. Conclusion: Recent studies provided some pieces of evidence that Bumetanide could be a novel pharmacological agent in treating core symptoms of ASD. Future studies need to be conducted in order to confirm the efficacy of this medication in individuals with ASD.