Sertraline in Adults With Pervasive Developmental Disorders

Abstract

The short-term efficacy and tolerability of sertraline for adults with pervasive developmental disorders (PDDs) were assessed in this investigation. Forty-two adults with PDDs (autistic disorder, N = 22; Asperger's disorder, N = 6; and PDD not otherwise specified [NOS], N = 14) participated in a 12-week, open-label, systematic trial of sertraline. Behavioral ratings of repetitive symptoms, aggression, and social relatedness were obtained at baseline and after 4, 8, and 12 weeks of sertraline administration. Twenty-four (57%) of 42 patients showed significant improvement, primarily in repetitive and aggressive symptoms. Statistically significant changes in measures of social relatedness did not occur. Patients with autistic disorder and PDD NOS did significantly better than those with Asperger's disorder. Based on global improvement item criteria from the Clinical Global Impression Scale, 15 of 22 (68%) patients with autistic disorder, none of six (0%) patients with Asperger's disorder, and 9 of 14 (64%) patients with PDD NOS were categorized as treatment responders. Sertraline was well tolerated; no adverse cardiovascular effects, extrapyramidal symptoms, or seizures were identified. These findings suggested that sertraline may be an effective treatment for interfering repetitive and aggressive symptoms in adults with PDDs. Definitive statements about the efficacy and tolerability of sertraline for treating adults with PDDs must await results from double-blind, placebo-controlled trials. These preliminary results should not be generalized to include children and adolescents with PDDs.

Medications for Adolescents and Young Adults With Autism Spectrum Disorders: A Systematic Review

“…Four studies were fair quality, 5-7,11 and 4 were poor. 4,[8][9][10] The most consistent findings were identified for antipsychotic medications. An RCT studying risperidone found improvements in aggression, repetitive behavior, sensory motor behaviors, and overall behavioral symptoms.…”

“…Of these, 5 were randomized controlled trials (RCTs) and 3 were case series. We located 3 studies addressing antipsychotic medications [4][5][6] ; 5 studies addressing serotonin reuptake inhibitor (SRI) medications 5,[7][8][9][10] ; and 1 study addressing the opioid receptor antagonist naltrexone. 11 Tables 3 and 4 summarize study characteristics and key results.…”

“…5,[7][8][9][10] One fair-quality RCT 7 investigated the efficacy of fluvoxamine in adults with autistic disorder. Participants were not receiving any psychotropic medications for at least 6 weeks before starting the trial.…”

“…5 Three case series of SRIs were also identified, including sertraline, fluoxetine, and clomipramine, with each study reporting some benefit to treatment. [8][9][10] A recent study not meeting criteria for this review also contributes to the limited data on SRIs. Hollander et al 14 reported a placebo-controlled RCT of fluoxetine that included 37 individuals with ASD (mean age: 34.31 years).…”

The Selective Serotonin Reuptake Inhibitor Sertraline: Its Profile and Use in Psychiatric Disorders

“…In case reports and small series, sertraline has been shown to be effective in the treatment of depression and behavioral disturbance associated with a variety of neurological conditions, including Parkinson's disease (92); Huntington's disease (192); post-stroke pathologic crying (179); stroke-associated lability of mood (33); multiple sclerosis (208); pervasive developmental disorder in children, adolescents, and adults (68,150); ADHD and Gilles de la Tourette's syndrome (74); and poorly defined impulsive violent behavior (31).…”