Lumateperone treatment of Intermittent explosive disorder in those with Autism spectrum disorder

Introduction The use of lumateperone in reducing aggression in patients with autism spectrum disorder (ASD) and intermittent explosive disorder (IED) has not heretofore been described. Methods Case 1 is a non-verbal 18-year-old male with autism who presented with anger and aggression, biting his hands, intermittently grunting, and screaming. The patient's hostility subsided after ten days of establishing lumateperone 42mg nightly, in cross-titration with aripiprazole. Case 2 is a non-verbal 18-year-old male with a history of hypsarrhythmia, and Lennox-Gastaut syndrome, presented with similar aggression coincident increase in the frequency of myoclonic seizures. Management was initiated with 42mg of lumateperone nightly. Aggression and hostility were remitted after ten days and one month, respectively, for cases 1 and 2; however, the seizures persisted in Case 2. Conclusion Due to its dual action on dopamine D2 receptors and better side effect profile compared to other antipsychotics, the authors encourage a trial of lumateperone in treating aggression associated with ASD and IED.