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 .
Risperidone in children with autism and serious behavioral problems.
BACKGROUND Atypical antipsychotic agents , which block postsynaptic dopamine and serotonin receptors , have advantages over traditional antipsychotic medications in the treatment of adults with schizophrenia and may be beneficial in children with autistic disorder who have serious behavioral disturbances . However , data on the safety and efficacy of atypical antipsychotic agents in children are limited . METHODS We conducted a multisite , r and omized , double-blind trial of risperidone as compared with placebo for the treatment of autistic disorder accompanied by severe tantrums , aggression , or self-injurious behavior in children 5 to 17 years old . The primary outcome measures were the score on the Irritability subscale of the Aberrant Behavior Checklist and the rating on the Clinical Global Impressions - Improvement ( CGI-I ) scale at eight weeks . RESULTS A total of 101 children ( 82 boys and 19 girls ; mean [ + /-SD ] age , 8.8+/-2.7 years ) were r and omly assigned to receive risperidone ( 49 children ) or placebo ( 52 ) . Treatment with risperidone for eight weeks ( dose range , 0.5 to 3.5 mg per day ) result ed in a 56.9 percent reduction in the Irritability score , as compared with a 14.1 percent decrease in the placebo group ( P<0.001 ) . The rate of a positive response , defined as at least a 25 percent decrease in the Irritability score and a rating of much improved or very much improved on the CGI-I scale , was 69 percent in the risperidone group ( 34 of 49 children had a positive response ) and 12 percent in the placebo group ( 6 of 52 , P<0.001 ) . Risperidone therapy was associated with an average weight gain of 2.7+/-2.9 kg , as compared with 0.8+/-2.2 kg with placebo ( P<0.001 ) . Increased appetite , fatigue , drowsiness , dizziness , and drooling were more common in the risperidone group than in the placebo group ( P<0.05 for each comparison ) . In two thirds of the children with a positive response to risperidone at eight weeks ( 23 of 34 ) , the benefit was maintained at six months . CONCLUSIONS Risperidone was effective and well tolerated for the treatment of tantrums , aggression , or self-injurious behavior in children with autistic disorder . The short period of this trial limits inferences about adverse effects such as tardive dyskinesia
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 .