Brexpiprazole Treatment in a Child With Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder (ADHD), and Trauma-Associated Hoarding Symptoms: A Case Report

Children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) frequently present with multiple psychiatric comorbidities, often accompanied by severe emotional dysregulation and behavioral disturbances that complicate diagnosis and treatment. We describe a child with comorbid ASD and ADHD who also met diagnostic criteria for hoarding disorder and separation anxiety disorder and exhibited trauma-related symptoms. The patient showed minimal response to psychotherapy and conventional pharmacological interventions. Although comprehensive multidisciplinary support was provided, severe emotional outbursts and irritability persisted, and treatment with approved antipsychotics and ADHD medications was limited by adverse effects. Adjunctive treatment with brexpiprazole was subsequently initiated. Following treatment, some improvement in hoarding behaviors and social motivation was observed. This case highlights the therapeutic challenges associated with managing complex neurodevelopmental conditions with multiple psychiatric comorbidities. These findings may provide insight into the interaction between neurodevelopmental vulnerability and trauma-related psychopathology and suggest a possible pharmacological consideration for treatment-resistant cases.