Journal
ARCHIVES OF GENERAL PSYCHIATRY
Volume 66, Issue 6, Pages 583-590Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/archgenpsychiatry.2009.30
Keywords
-
Categories
Funding
- NICHD NIH HHS [U01-HD045023, U01 HD045023] Funding Source: Medline
- NIMH NIH HHS [U54 MH066418, U54-MH066494, U54 MH066494, U54 MH068172, U54-MH068172, U54 MH066673, U54-MH066398, U54 MH066398, U54-MH066673] Funding Source: Medline
Ask authors/readers for more resources
Context: Selective serotonin reuptake inhibitors are widely prescribed for children with autism spectrum disorders. Objectives: To determine the efficacy and safety of citalopram hydrobromide therapy for repetitive behavior in children with autism spectrum disorders. Design: National Institutes of Health-sponsored randomized controlled trial. Setting: Six academic centers, including Mount Sinai School of Medicine, North Shore-Long Island Jewish Health System, University of North Carolina at Chapel Hill, University of California at Los Angeles, Yale University, and Dartmouth Medical School. Participants: One hundred forty-nine volunteers 5 to 17 years old(mean [SD] age, 9.4 [3.1] years) were randomized to receive citalopram(n = 73) or placebo(n = 76). Participants had autistic spectrum disorders, Asperger disorder, or pervasive developmental disorder, not otherwise specified; had illness severity ratings of at least moderate on the Clinical Global Impressions, Severity of Illness Scale; and scored at least moderate on compulsive behaviors measured with the Children's Yale-Brown Obsessive Compulsive Scales modified for pervasive developmental disorders. Interventions: Twelve weeks of citalopram hydrobromide (10 mg/5 mL) or placebo. The mean (SD) maximum dosage of citalopram hydrobromide was 16.5 (6.5) mg/d by mouth (maximum, 20 mg/d). Main Outcome Measures: Positive response was defined by a score of much improved or very much improved on the Clinical Global Impressions, Improvement subscale. An important secondary outcome was the score on the Children's Yale-Brown Obsessive Compulsive Scales modified for pervasive developmental disorders. Adverse events were systematically elicited using the Safety Monitoring Uniform Report Form. Results: There was no significant difference in the rate of positive response on the Clinical Global Impressions, Improvement subscale between the citalopram-treated group (32.9%) and the placebo group (34.2%) (relative risk, 0.96; 95% confidence interval, 0.61-1.51; P > . 99). There was no difference in score reduction on the Children's Yale-Brown Obsessive Compulsive Scales modified for pervasive developmental disorders from baseline (mean [SD], -2.0 [3.4] points for the citalopram-treated group and -1.9[2.5] points for the placebo group; P = . 81). Citalopram use was significantly more likely to be associated with adverse events, particularly increased energy level, impulsiveness, decreased concentration, hyperactivity, stereotypy, diarrhea, insomnia, and dry skin or pruritus. Conclusion: Results of this trial do not support the use of citalopram for the treatment of repetitive behavior in children and adolescents with autism spectrum disorders.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available