Nicolás Meza leads international review on antipsychotics in people with autism
28/05/2025
An international team of researchers from Chile, Argentina, Germany, Australia, Canada and the UK, led by Nicolás Meza from the Interdisciplinary Centre for Health Studies (CIESAL) at the Universidad de Valparaíso, has published a high-impact systematic review in the prestigious Cochrane Database of Systematic Reviews. The paper analysed the efficacy and safety of atypical antipsychotics in children and adults with autism spectrum disorder (ASD), through a network meta-analysis of randomised clinical trials.
The study, which included 17 trials with 1027 participants, comparatively evaluated risperidone, aripiprazole, lurasidone and olanzapine. Using network meta-analyses and direct comparisons, the efficacy of different atypical antipsychotics was examined in reducing symptoms such as irritability, aggression, obsessive-compulsive behaviours and inappropriate language in people with ASD. The team applied Cochrane and GRADE methodological standards to assess the certainty of the evidence.
The findings indicated that risperidone and aripiprazole may have moderate positive effects in reducing irritability symptoms in children with autism in the short term, whereas lurasidone is unlikely to have a significant effect. However, the certainty of the evidence was low or very low for most outcomes, due to risks of bias and imprecision in the available studies.
In addition to potential benefits, the researchers highlighted adverse effects such as weight gain and extrapyramidal symptoms. The team concluded that more robust clinical trials with larger samples – particularly in adult populations – are needed to properly assess the risk-benefit balance of these drugs.
Nicolás Meza is a young CIESAL researcher currently working at the School of Medicine supporting the Kaplan Foundation team and teaching Research Methodology and Evidence-Based Medicine. Nicolás is a doctoral candidate in the PhD programme in Research Methodology and Public Health at the Autonomous University of Barcelona. The study also included Dr. Reginald Rees from the Department of Psychiatry, Dr. Valeria Rojas from Neuropediatrics, and Dr. Eva Madrid from the Department of Public Health.
The Cochrane Database of Systematic Reviews is one of the most influential journals in medicine. Published by the Cochrane Collaboration and edited by Wiley, the journal focuses on systematic reviews in health. Each article is prepared under strict methodological standards and peer-reviewed by experts. With an impact factor of more than 9 in recent years, CDSR is an essential reference for clinicians, researchers, institutions such as the WHO, and policy makers around the world.
This CIESAL-led effort highlights the active role of Latin American research in global scientific partnerships and reaffirms the commitment of participating institutions to the production of reliable evidence to guide clinical and policy decisions.
We would like to congratulate Dr. Meza on this achievement which clearly places CIESAL and the School of Medicine in a prestigious and competitive global position.