339. Brexpiprazole for emerging psychosis in an adolescent female with Asperger-type autism: a single-case clinical evaluation

Vollständiger Abstract

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Abstract Background Autism Spectrum Disorder (ASD), previously referred to as Asperger syndrome, is characterized by deficits in social communication, restricted interests, and rigid behavioral patterns. Although psychotic symptoms are not core features of ASD, adolescents with ASD are at increased risk of developing hallucinations, particularly under psychosocial stress. We present a case report using brexpiprazole in adolescents with ASD with psychotic symptoms. Aims & Objectives This study aims to evaluate the clinical response and tolerability of brexpiprazole in a 14-year-old female vocational high school student with ASD who presented with auditory hallucinations following significant academic and social stressors. Method A single case study design was employed. The participant was a 14-year-old female with ASD who developed daily auditory hallucinations over two months. Brexpiprazole was initiated at 0.5 mg/day and titrated to 1–2 mg/day. Clinical evaluation over six weeks included the frequency of hallucinations, functional performance at school, sleep pattern changes, and adverse effects. Psychosocial interventions included social skills training and family psychoeducation. Results After six weeks of treatment, hallucination frequency decreased by approximately 60%, shifting from daily episodes to 1–2 episodes per week. Anxiety and sleep disturbances improved significantly, and the patient showed better school functioning. No serious adverse effects were observed; only mild transient sedation occurred during the first week. The combination of brexpiprazole and structured psychosocial interventions demonstrated a synergistic effect in reducing psychotic symptoms and anxiety in an adolescent with ASD. Discussion & Conclusions Brexpiprazole appears to be effective and well-tolerated in managing psychotic symptoms in a 14-year-old female with ASD, particularly when integrated with social skill training and environmental support. Larger controlled studies are needed to further establish the efficacy and safety of brexpiprazole in adolescents with ASD presenting with psychosis.