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 .
Reactivity of serotonin in whole blood: relationship with drug response in obsessive-compulsive disorder
BACKGROUND Obsessive-compulsive disorder responds almost only to potent serotonin reuptake inhibitors . Previous studies have suggested a relation between serotonergic function and clinical outcome in serotonin reuptake inhibitor treatment of obsessive-compulsive disorder . METHODS In a r and omized , double-blind trial , comparing clomipramine , paroxetine , and a placebo in obsessive-compulsive disorder ,  serotonin levels in whole blood ( WB-5-HT ) were measured at baseline , after 1 week , and after 4 weeks of treatment and related to clinical outcome in 36 patients . RESULTS In patients treated with serotonin reuptake inhibitors  there was a pronounced decrease of WB-5-HT , variable after 1 week and uniformly maximal after 4 weeks . The decrease of WB-5-HT after 1 week of serotonin reuptake inhibitor treatment correlated negatively with clinical outcome after 12 weeks ( r = -.61 , p = .0006 ) ; hence , patients with slower WB-5-HT reactivity eventually responded better to treatment . Baseline WB-5-HT , but not WB-5-HT reactivity , was related to season . Depression , autistic traits , and previous serotonin reuptake inhibitor treatment predicted nonresponse . CONCLUSIONS A fast decrease of WB-5-HT was associated with poor clinical outcome . This may be related to faster serotonin efflux from platelets , which has previously been linked to autism . Further studies are necessary to identify the underlying mechanism and discern whether serotonin reuptake inhibitor-induced WB-5-HT decrease is clinical ly useful
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 .