Autism spectrum disorder
A neurodevelopmental condition with impaired social communication and restricted, repetitive behaviour patterns. Core interventions: behavioural therapy (ABA, ESDM), communication programs, speech therapy. No disease-specific pharmacotherapy exists for autism itself. Symptomatic drugs (antipsychotics for aggression, melatonin for sleep) are used for specific indications.
ICD-10 F843 drugs
Also known as: ASD, Autism
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DSulforaphane (isothiocyanate from broccoli sprouts)Not recommended · Plant isothiocyanate, supplement. Formed from glucoraphanin (Brassica oleracea) by myrosinase. Activator of the Nrf2-Keap1 pathwaySulforaphane is actively sold as «natural help for autism» after the Singh 2014 PNAS RCT. The study enrolled 44 boys and young men aged 13–27 with autism spectrum disorder receiving sulforaphane 50–150 µmol/day (~25–75 mg) or placebo × 18 weeks; the intervention group showed improvement on ABC and SRS scales, with the effect disappearing on discontinuation. Sample size small; multicentre RCTs with the same results have not been reproduced. AAP 2020 lists behavioural interventions (ABA, TEACCH, ESDM), speech and occupational therapy first-line for ASD; pharmacotherapy (risperidone, aripiprazole) – for marked aggression and self-injury; dietary supplements including sulforaphane are not in the guideline. If sulforaphane was recommended for a child with ASD instead of proven behavioural programmes, consider seeking a second opinion from a child psychiatrist.
- FCortexin (bovine brain cortex polypeptides)Not recommended · Other psychostimulants and nootropics (local classification)For ASD, AAP 2020, AACAP, and NICE CG170 international guidelines recommend early behavioural intervention (ABA, ESDM) and management of comorbidities (epilepsy, sleep, anxiety). Peptide preparations and nootropics are not first-line. Massive Cortexin prescribing in Russian ASD practice lacks international support.
- FProbiotics (Lactobacillus spp., Bifidobacterium spp., Saccharomyces boulardii)Not recommended · Probiotic microorganismsProbiotics for autism spectrum disorder have no evidence base. The 2018 Cochrane review (Parracho HM et al.) and 2021–2023 updates showed no convincing effect on core ASD symptoms. The American Academy of Pediatrics and AACAP do not include probiotics in their recommendations. Core ASD interventions: behavioural therapy, communication programs, early intervention. Positioning probiotics as «autism treatment» in post-Soviet marketing is particularly dangerous because it distracts families from evidence-based interventions and financially exploits parents in difficult circumstances.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit