A double-blind placebo-controlled trial of fluoxetine for repetitive behaviors and global severity in adult autism spectrum disorders.

Abstract

OBJECTIVE:

The effects of fluoxetine and placebo on repetitive behaviors and global severity were compared in adults with autism spectrum disorders (ASDs).

METHOD:

Adults with ASDs were enrolled in a 12-week double-blind placebo-controlled fluoxetine trial. Thirty-seven were randomly assigned to fluoxetine (N=22) or placebo (N=15). Dosage followed a fixed schedule, starting at 10 mg/day and increasing as tolerated up to 80 mg/day. Repetitive behaviors were measured with the compulsion subscale of the Yale-Brown Obsessive Compulsive Scale; the Clinical Global Impression (CGI) improvement scale was used to rate improvement in obsessive-compulsive symptoms and overall severity.

RESULTS:

There was a significant treatment-by-time interaction indicating a significantly greater reduction in repetitive behaviors across time for fluoxetine than for placebo. With overall response defined as a CGI global improvement score of 2 or less, there were significantly more responders at week 12 in the fluoxetine group than in the placebo group. The risk ratio was 1.5 for CGI global improvement (responders: fluoxetine, 35%; placebo, 0%) and 1.8 for CGI-rated improvement in obsessive-compulsive symptoms (responders: fluoxetine, 50%; placebo, 8%). Only mild and moderate side effects were observed.

CONCLUSIONS:

Fluoxetine treatment, compared to placebo, resulted in significantly greater improvement in repetitive behaviors, according to both the Yale-Brown compulsion subscale and CGI rating of obsessive-compulsive symptoms, as well as on the CGI overall improvement rating. Fluoxetine appeared to be well tolerated. These findings stand in contrast to findings in a trial of citalopram for childhood autism.

• Authors: Eric Hollander, Latha Soorya, William Chaplin, Evdokia Anagnostou, Bonnie P Taylor, Casara J Ferretti, Stacey Wasserman, Erika Swanson, Cara Settipani
• Journal: The American journal of psychiatry (Am J Psychiatry) Vol. 169 Issue 3 Pg. 292-9 (Mar 2012) ISSN: 1535-7228 [Electronic] United States
• PMID: 22193531 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Serotonin Uptake Inhibitors
• Fluoxetine

Topics

• Adolescent
• Adult
• Child
• Child Development Disorders, Pervasive (drug therapy, psychology)
• Double-Blind Method
• Female
• Fluoxetine (therapeutic use)
• Humans
• Male
• Middle Aged
• Obsessive Behavior (drug therapy)
• Psychiatric Status Rating Scales
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Severity of Illness Index
• Stereotypic Movement Disorder (drug therapy)
• Treatment Outcome
• Young Adult