Objectives. Infantile autism is a severe developmental disorder characterized by marked social deficits, language impairment, and a restricted range of stereotyped repetitive behaviours.
Review. Autism is a consequence of disturbances in the anatomical development of the brain, associated with CNS neurotransmission disorders and neuropsychological deficits. Disorders have been found in autism not only as regards the CNS serotoninergic transmission, but also peripheral serotonin metabolism and serotonin receptors affinity to agonists and antagonists. A series of studies have shown elevated serotonin concentrations in the brain, in blood, and urine. In support of this, decreased 5-HT-2 binding has been reported. An association study was performed to elucidate the role of the serotonin transporter gene as a susceptibility factor for autism. Besides, in autistic children the CNS cholinergic transmission is abnormal, as evidenced both by post mortem brain studies and by changed levels of dopamine, acetylcholine and its metabolites in urine samples. The altered CNS metabolism of opioids is associated with aggression and autoaggression - both reduced after admininstration of naltrexone, an opioid agonist. Moreover, some neuropeptides (including VIP, oxitocine, and secretine) are involved in the pathogenesis of autism.
Conclusions. In view of the complex pathogenesis of infantile autism new treatment methods must be sought. It can be hoped that research into neurochemical abnormalities in the CNS will not only will increase our understanding of action of the already existing drugs used in the treatment of autism, but perhaps also contribute to discovering new methods ofpharmacotherapy of this condition.