TABLE 1.

Current therapeutic approaches for ASD patients.

Treatment types	Treatment subtypes	Examples of drugs	Advantages	Side effects	References
Pharmacological treatments	Psychostimulants	Methylphenidate	Impulsivity↓ Hyperactivity↓ ADHD symptoms of autistic patients↓	Appetite ↓ Problem in the digestive tractuparrow Headache uparrow	(48, 49)
		Amphetamines	Impulsivity↓ Hyperactivity↓ ADHD symptoms of autistic patients↓	Irritabilityuparrow Sleep disorders, anxiety, intensification of behaviors in mixed amphetamine salts prescription	(48, 50)
	Atypical antipsychotic drugs	Risperidone	Hyperactivity↓ Repetitive behaviors↓ Aggression↓ Social withdrawal↓ Anxiety↓ Nervousness↓ Depression↓ Irritability↓	Weight gainuparrow Fatigueuparrow Drowsinessuparrow Dizziness↓	(48)
		Aripiprazole	Irritability↓	Sedationuparrow Droolinguparrow Tremoruparrow	(48)
		Quetiapine	Aggression↓ Sleep disturbance↓	Sedationuparrow Aggressionuparrow Weight gainuparrow	(48, 51)
		Ziprasidone	Aggression↓ Agitation↓ Irritability↓	Weight loss↓	(48)
		Olanzapine	Anger↓ Irritability↓ Anxiety↓ Hyperactivity↓ Social withdrawal↓ Language usageuparrow	Weight gainuparrow Appetite changes Impaired insulin sensitivityuparrow	(48)
	Antidepressant drugs	Fluoxetine	Repetitive behaviors↓ Anxiety↓	Restlessnessuparrow Agitationuparrow Hyperactivityuparrow Problems in appetite Sleep disturbanceuparrow	(48, 52)
		Sertraline	Irritability↓ Anxiety↓ Aggressive behaviors↓ Repetitive behaviors↓		(48)
		Citalopram	Anxiety↓ Aggression↓ Repetitive behaviors↓ Irritability↓	Hyperactivityuparrow Insomniauparrow Diarrheauparrow	(48)
		Escitalopram	Impulsivity↓ Improving Psychosocial behaviorsuparrow	Hyperactivityuparrow Aggressionuparrow Irritabilityuparrow	(48)
		Fluvoxamine	Anxiety↓ Repetitive behaviors↓ Aggression↓	Akathisiauparrow Agitationuparrow Sleep difficultiesuparrow Headachesuparrow Appetite changes	(48)
	Alpha-2 adrenergic receptor agonists	Clonidine	Hyperarousal behaviors↓ Social interactionsuparrow Irritability↓ Hyperactivity↓ Sleep initiation latency↓ Insomnia↓ Aggressive behaviors↓	Sleepinessuparrow Sedationuparrow Fatigueuparrow Blood pressure↓ Irritabilityuparrow Aggressive behavioruparrow	(48, 53)
		Guanfacine-ER	Hyperactivity↓ Impulsiveness↓ Distractibility↓	Drowsinessuparrow Fatigueuparrow Appetite changes	(48)
	Neuropeptides	Oxytocin	Repetitive behaviors↓ Cognitive impairments↓ Core symptoms↓ Interpersonal communicationsuparrow	Delivery of small amounts of drug to the brain through nasal spray Nasal discomfortuparrow Skin problemsuparrow Diarrheauparrow Irritabilityuparrow Fatigueuparrow	(48, 54)
		Vasopressin	Interpersonal communicationsuparrow Social interactionsuparrow	Ventricular arrhythmias, coronary ischemia, myocardial infarction, and high blood pressure in case of non-inhalation administration methods Bronchospasm, hyponatremia, angioedema, urticarial, peripheral vasoconstrictions, and local irritation at the injection site	(48, 55)
Non-pharmacological treatments	Complementary and integrative methods	Mental and physical activities	ASD-related destructive behaviors↓		(48, 56)
	Music therapy	Sung-word listening	Preserving the Frontal-temporal functional connectivity Mentalizinguparrow Regulate both emotions and moods Cognitive impairments↓ Modulating senses Modulating action-specific perception		(48)
	CBT		Anxiety↓ Depression↓ OCD↓ Disrupti ve behaviors↓ Core symptoms↓		(48)
	SBT	PECS	Improving emotional behaviors Social interactionsuparrow Interpersonal communicationsuparrow Mental activityuparrow Independenceuparrow		(48)
		Speech generating devices
		Self-management
		RIT
	Dietary and nutritional supplements	Omega-3 fatty acids	Neurotransmissionuparrow Oxidative stress↓ Inflammation↓ Immune system functionuparrow Social interactionsuparrow Attention deficits↓	Gastrointestinal problemsuparrow Irritabilityuparrow Hyperactivityuparrow Stereotypic behaviorsuparrow Social withdrawaluparrow	(48)
		Methyl B12	Improving redox balance Homocysteine levelsuparrow Improving CGI-I score due to the increase in levels of methionine and reduction in S-adenosyl-lhomocysteine (SAH) Improving the ratio of SAM to SAH due to the improvement in cellular methylation capacity	No significant side effects have been reported	(57, 58)
		Vitamin D	Anti-inflammatory effects in the brainuparrow Regulating serotonin synthesis Improving the ABC, CARS, Autism Treatment Evaluation Checklist, and SRS scores		(57)
		Folinic acid	Improving neurological symptoms by regulating folate concentrations in cerebrospinal fluid Verbal communicationuparrow	High levels of maternal plasma folate levels during pregnancy can be associated with high risk of ASD.	(57, 59)
		Camel milk	Anti-inflammatory effectsuparrow Antibacterial effects on autistic enterocolitis uparrow Improving CARS score		(57)
		GFCF	Although in some studies, the use of GFCF has improved autistic behaviors, but in some trials, no significant difference was observed between the patient and control groups. As these two substances neither improve nor worsen the symptoms and this diet is an expensive diet, GFCF is not recommended as a main therapeutic approach for ASD	Social isolationuparrow Delay in the diagnosis of food allergy, celiac disease, or lactose intoleranceuparrow	(57, 60)
		Probiotics	Gastrointestinal symptoms↓ Improving Total Behavior Problem score		(57)
		Digestive enzyme	Improving emotional response Improving general impression autistic score ASD-related behaviors↓ Gastrointestinal symptoms↓		(57)
		SFN	Improving ABC, SRS, and CGI-I scores	Insomniauparrow Flatulenceuparrow Constipationuparrow Weight gainuparrow Vomitinguparrow Diarrheauparrow Aggressionuparrow Seasonal allergiesuparrow	(57, 61)
	Herbal medicine	Panax ginseng	Improving ASD-related abnormal behaviors		(62)
		Ukgansangajinpibanha granule	Aggressive behavior↓ Anxiety↓ Chronic pruritus↓ Insomnia↓		(63)

ABC, Autism Behavior Checklist; ADHD, Attention deficit hyperactivity disorder; ASD, Autism spectrum disorder; CARS, Childhood Autism Rating Scale; CBT, Cognitive behavioral therapy; CGI-I, Clinical Global Impression Scale of Improvement; GFCF, Gluten-free and casein-free; Guanfacine-ER, Guanfacine extended release; PECS, Picture Exchange Communication System; RIT, Reciprocal imitation training; SBT, Social behavioral therapy; SFN, Sulforaphane; TER, Total effective rate.