Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD)

Williams, Katrina; Brignell, Amanda; Randall, Melinda; Silove, Natalie; Hazell, Philip

doi:10.1002/14651858.cd004677.pub3

Cited by 213 publications

(191 citation statements)

References 43 publications

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“…119 (10) 23 (2) 10 (1) 39 (3) 54 (4) 17 (1.4) 46 (4) 6-11 y (951) 422 (44) 119 (13) 60 (6) 247 (26) 111 (12) 136 (14) 129 (14) 12-17 y (276) 176 (64) 55 (20) 31 (11) 92 (33) 39 (14) 88 (32) 64 (23) Total 760 (27) 208 (7) 130 (5) 379 (13) 205 (7) 241 (8) 239 (8) …”

Section: Demographic Variations In Psychotropic Medication Useunclassified

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Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

et al. 2012

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OBJECTIVES: The goal of this study was to examine rates of psychotropic medication use and identify associated child and family characteristics among children and adolescents with autism spectrum disorder (ASD) enrolled in an autism registry maintained by the Autism Treatment Network (ATN). METHODS:The sample, derived from the ATN registry, consists of 2853 children aged 2 to 17 years with diagnoses of ASD supported by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the Autism Diagnostic Observation Schedule with available data on medication use. As part of initial enrollment in the registry, parents completed questionnaires on current psychotropic medication use, psychiatric and medical conditions, and demographics. RESULTS:Of the 2853 children, 763 (27%) were taking $1 psychotropic medication; 15% were prescribed 1 medication, 7.4% received 2 medications, and 4.5% received $3. Among children aged 3 to 5 years, 11% were taking $1 psychotropic medication; among 6-to 11-year-old children, 46%; and 66% of adolescents aged 12 to 17 years were taking at $1 psychotropic medication. A parent report of comorbid diagnosis of attention-deficit/hyperactivity disorder, bipolar disorder, obsessive-compulsive disorder, depression, or anxiety was associated with a high rate of use, with 80% receiving $1 psychotropic medication. Only 15% of children with no comorbid psychiatric disorder were taking psychotropic medication. Psychotropic medication use was also related to sleep and gastrointestinal problems. CONCLUSIONS:The prescription of psychotropic medications in this registry sample is highly related to comorbid psychiatric disorder. Other factors associated with use include medical comorbidities, race, ethnicity, and older age. Pediatrics 2012;130:S69-S76

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Section: Demographic Variations In Psychotropic Medication Useunclassified

“…Race (N = 2853) P , .0001 P = .003 P = .16 P , .0001 P = .22 P = .0002 P = .35 Caucasian (n = 2226) 610 (27) 181 (8) 108 (5) 328 (15) 167 (8) 213 (10) 193 (9) Non-Caucasian (n = 627)…”

Section: Demographic Variations In Psychotropic Medication Usementioning

confidence: 99%

Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

et al. 2012

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“…Thus, we included 17 systematic reviews. 4,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Results from systematic reviews A summary of each systematic review is presented narratively below. In addition, Table 2 4,10-25 presents the issues addressed, the main findings from each systematic review and the quality of the evidence (based on the GRADE approach).…”

Section: Search Resultsmentioning

confidence: 99%

“…The review 21 included nine heterogeneous RCTs (320 adults or children) assessing fluoxetine (three RCTs), fluvoxamine (two RCTs), fenfluramine (two RCTs) and citalopram (two RCTs).…”

Section: Selective Serotonin Reuptake Inhibitors (Ssris)mentioning

confidence: 99%

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?

et al. 2017

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CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs) include autistic disorder, Asperger's disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS:We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/ magnesium and SSRI for children. CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed. RESUMO MÉTODOS:Nós incluímos e resumimos os resultados de revisões sistemáticas Cochrane sobre intervenções para TEA. RESULTADOS: Foram incluídas 17 revisões que encontraram evidências fracas de benefícios da acupuntura, dietas isentas de glúten e caseína, intervenção comportamental intensiva precoce, musicoterapia, intervenção precoce mediada pelos pais, grupos de habilidades sociais, modelo cognitivo de Teoria da Mente, aripiprazol, risperidona, antidepressivos tricíclicos, inibidores seletivos da recaptação da serotonina (ISRS); o último apenas para adultos. Nenhum benefício foi encontrado com terapias sonoras, agentes quelantes, oxigenoterapia hiperbárica, ômega-3, secretina, vitamina B6/magnésio e ISRS para crianças. CONCLUSÃO: Acupuntura, dietas sem glúten e caseína, intervenção comportamental intensiva precoce, musicoterapia, intervenção precoce mediada pelos pais, grupos de habilidades sociais e modelo cognitivo de Teoria da Mente parecem ter benefícios para pacientes com TEA (evidência de qualidade muito baixa a baixa). Aripiprazol, risperidona, antidepressivos tricíclicos e ISRS (o último apenas para adultos) também apresentam algum benefício, embora estejam associados a maior risco de event...

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“…SSRIs block the re-uptake of serotonin at the synapse, thus increasing the availability of serotonin and the activation of serotonin receptors [15]. In children and adults, SSRIs have shown limited positive outcome, although all the studies have been with small sample sizes, with potential risk of bias [16,17].…”

Section: Review Articlementioning

confidence: 99%

Pharmacobiological Treatments in Autism Spectrum Disorders

Jayaraman¹,

Mundkur²

2017

IJCRR

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Autism spectrum disorders (ASD) refer to a group of neuro-developmental disorders affecting young children and adults. Currently, the treatment options for ASD are mostly restricted to treating its symptoms. Among the various approaches for treating ASD, pharmacobiology-based treatments are numerous. Our objective is to review the up-to-date information on different types of medications and briefly discuss the evidence-based potential of these treatments in ASD therapy. PubMed searches for reports and reviews on clinical data from the last 15 years, between 2002-2017, using search terms of each category of treatment along with the terms "autism", "mechanism", and/or "side effects" were conducted. Several pharmacobiological interventions have been prescribed for ASD, including antipsychotics, stimulants, antidepressants, supplements, and special diets. However, none of these methods is an effective ASD treatment, and only few show much promise. We provide a brief overview of the current pharmacobiological treatments for ASD, their mechanisms of action, and clinical research-based evidence on their effectiveness. Based on our review, we recommend that caution should be exercised when choosing a pharmacobiological treatment method for ASD as majority of existing evidence is not from large-scale long-term high quality studies.Future research should focus on rigorous investigative design, long-term implementation, and meaningful uniform outcome measurements.

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Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD)

Abstract: There is no evidence of effect of SSRIs in children and emerging evidence of harm. There is limited evidence of the effectiveness of SSRIs in adults from small studies in which risk of bias is unclear.

Cited by 213 publications

References 43 publications

Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?

Pharmacobiological Treatments in Autism Spectrum Disorders

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