AUTHORS ' CONCLUSIONS There is no evidence of effect of SSRIs in children and emerging evidence of harm .
BACKGROUND Autism spectrum disorders ( ASD ) are characterised by abnormalities in social interaction and communication skills , as well as stereotypic behaviours and restricted activities and interests .
Selective serotonin reuptake inhibitors ( SSRIs ) are prescribed for the treatment of conditions often comorbid with ASD such as depression , anxiety and obsessive-compulsive behaviours .
OBJECTIVES To determine if treatment with an SSRI:1 .
improves the core features of autism ( social interaction , communication and behavioural problems);2 .
improves other non-core aspects of behaviour or function such as self-injurious behaviour;3 .
improves the quality of life of adults or children and their carers;4 .
has short- and long-term effects on outcome ; 5 .
causes harm .
A Placebo Controlled Crossover Trial of Liquid Fluoxetine on Repetitive Behaviors in Childhood and Adolescent Autism
Repetitive behaviors are a core symptom domain in autism that has been linked to alterations in the serotonin system . While the selective serotonin-receptive inhibitor fluvoxamine has been shown to be effective in adults with autism , as yet no published placebo controlled trials with these agents document safety and efficacy in children with autism . This study examines the selective serotonin reuptake inhibitor liquid fluoxetine in the treatment of repetitive behaviors in childhood and adolescent autism spectrum disorders ( ASDs ) . In total , 45 child or adolescent patients with ASD were r and omized into two acute 8-week phases in a double-blind placebo-controlled crossover study of liquid fluoxetine . Study design included two r and omized 8-week fluoxetine and placebo phases separated by a 4-week washout phase . Outcome measures included measures of repetitive behaviors and global improvement . Low-dose liquid fluoxetine ( mean final dose : 9.9±4.35 mg/day ) was superior to placebo in the treatment of repetitive behaviors by CY-BOCS compulsion scale . The effect size was in the moderate to large range , and the doses used were low . Liquid fluoxetine was only slightly , and not significantly , superior to placebo on CGI autism score partially due to a phase order effect . However , fluoxetine was marginally superior to placebo on a composite measure of global effectiveness . Liquid fluoxetine did not significantly differ from placebo  on treatment emergent side effects . Liquid fluoxetine in low doses is more effective than placebo in the treatment of repetitive behaviors in childhood autism . Limitations include small sample size and the crossover design of the study . Further replication and long-term maintenance trials are needed
AUTHORS ' CONCLUSIONS There is no evidence of effect of SSRIs in children and emerging evidence of harm .
BACKGROUND Autism spectrum disorders ( ASD ) are characterised by abnormalities in social interaction and communication skills , as well as stereotypic behaviours and restricted activities and interests .
Selective serotonin reuptake inhibitors ( SSRIs ) are prescribed for the treatment of conditions often comorbid with ASD such as depression , anxiety and obsessive-compulsive behaviours .
OBJECTIVES To determine if treatment with an SSRI:1 .
improves the core features of autism ( social interaction , communication and behavioural problems);2 .
improves other non-core aspects of behaviour or function such as self-injurious behaviour;3 .
improves the quality of life of adults or children and their carers;4 .
has short- and long-term effects on outcome ; 5 .
causes harm .