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Citalopram no better than placebo treatment for children with autism spectrum disorders
June 02, 2009Citalopram, a medication commonly prescribed to children with autism spectrum disorders (ASD), was no more effective than a placebo at reducing repetitive behaviors, according to researchers funded by the National Institute of Mental Health (NIMH) and other NIH institutes. The study was published in the June 2009 issue of Archives of General Psychiatry.
"Parents of children with autism spectrum disorders face an enormous number of treatment options, not all of which are research-based," said NIMH Director Thomas R. Insel, M.D. "Studies like this help us to better understand which treatments are likely to be beneficial and safe."
The researchers say their findings do not support using citalopram to treat repetitive behaviors in children with ASD. Also, the greater frequency of side effects from this particular medication compared to placebo illustrates the importance of placebo-controlled trials in evaluating medications currently prescribed to this population.
Citalopram is in a class of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) that is sometimes prescribed for children with ASD to reduce repetitive behaviors. These behaviors, a hallmark of ASD, include stereotypical hand flapping, repetitive complex whole body movements (such as spinning, swaying, or rocking over and over, with no clear purpose), repetitive play, and inflexible daily routines.
Past research suggested that some children with ASD have abnormalities in the brain system that makes serotonin, a brain chemical that, among many other functions, plays an important role in early brain development. Children with obsessive compulsive disorder (OCD) may also have serotonin abnormalities and have repetitive or inflexible behaviors. OCD is effectively treated with SSRIs, leading some researchers to wonder whether similar treatment may reduce repetitive behaviors in children with ASD. So far, studies have produced mixed results, but SSRIs remain among the most frequently prescribed medications for children with ASD.
Researchers in the Studies to Advance Autism Research and Treatment (STAART) network, funded by five NIH institutes, conducted a six-site, randomized controlled trial comparing the effectiveness and safety of using the SSRI citalopram (Celexa) versus placebo to treat repetitive behaviors in children with ASD. The study included 149 participants, ages 5󈝽, who had autism, Asperger disorder, or pervasive developmental disorder-not otherwise specified (PDD-NOS).
After 12 weeks of treatment, roughly 1 out of 3 children in both groups-32.9 percent of those treated with citalopram and 34.2 percent those treated with placebo-showed fewer or less severe repetitive symptoms.
"Adverse symptoms were common in both groups, probably reflecting common childhood ailments as well as the changing nature of symptoms associated with ASD," according to Bryan King, M.D., director of child and adolescent psychiatry at Seattle Children's Hospital and lead author on the study. However, reports of increased energy, impulsiveness, decreased concentration, hyperactivity, diarrhea, insomnia, and dry skin were more common in the citalopram group.
According to the researchers, the study results may challenge the underlying premise that repetitive behaviors in children with ASD are similar to repetitive and inflexible behaviors in OCD.
NIH/National Institute of Mental Health
Citalopram is in a class of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) that is sometimes prescribed for children with ASD to reduce repetitive behaviors. These behaviors, a hallmark of ASD, include stereotypical hand flapping, repetitive complex whole body movements (such as spinning, swaying, or rocking over and over, with no clear purpose), repetitive play, and inflexible daily routines.
Past research suggested that some children with ASD have abnormalities in the brain system that makes serotonin, a brain chemical that, among many other functions, plays an important role in early brain development. Children with obsessive compulsive disorder (OCD) may also have serotonin abnormalities and have repetitive or inflexible behaviors. OCD is effectively treated with SSRIs, leading some researchers to wonder whether similar treatment may reduce repetitive behaviors in children with ASD. So far, studies have produced mixed results, but SSRIs remain among the most frequently prescribed medications for children with ASD.
Researchers in the Studies to Advance Autism Research and Treatment (STAART) network, funded by five NIH institutes, conducted a six-site, randomized controlled trial comparing the effectiveness and safety of using the SSRI citalopram (Celexa) versus placebo to treat repetitive behaviors in children with ASD. The study included 149 participants, ages 5󈝽, who had autism, Asperger disorder, or pervasive developmental disorder-not otherwise specified (PDD-NOS).
After 12 weeks of treatment, roughly 1 out of 3 children in both groups-32.9 percent of those treated with citalopram and 34.2 percent those treated with placebo-showed fewer or less severe repetitive symptoms.
"Adverse symptoms were common in both groups, probably reflecting common childhood ailments as well as the changing nature of symptoms associated with ASD," according to Bryan King, M.D., director of child and adolescent psychiatry at Seattle Children's Hospital and lead author on the study. However, reports of increased energy, impulsiveness, decreased concentration, hyperactivity, diarrhea, insomnia, and dry skin were more common in the citalopram group.
According to the researchers, the study results may challenge the underlying premise that repetitive behaviors in children with ASD are similar to repetitive and inflexible behaviors in OCD.
NIH/National Institute of Mental Health
Autism Spectrum Disorder Current Events and Autism Spectrum Disorder News RSSAutism Consortium symposium draws record number of researchers, advocates, parents for autism update
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National autism research led by Leicester specialist
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Children with autism need to be taught in smaller groups, pilot study confirms
Since the 1970s, there has been much debate surrounding the fact that individuals with autism have difficulty in understanding speech in situations where there is background speech or noise.
Further gene mutations linked to autism risk
Pieces in the complex autism inheritance puzzle are emerging in the latest study from a research team including geneticists from the University of Pennsylvania School of Medicine and The Children's Hospital of Philadelphia (CHOP).
More gene mutations linked to autism risk
More pieces in the complex autism inheritance puzzle are emerging in the latest study from a research team including geneticists from The Children's Hospital of Philadelphia, the University of Pennsylvania School of Medicine and several collaborating institutions.
Antidepressant ineffective against autism spectrum disorder children's obsessive behavior
A new multi-center study, conducted at The Feinstein Institute for Medical Research in collaboration with five other centers throughout the country, tested the commonly prescribed antidepressant citalopram and found that it was no more effective than placebo in altering obsessive features of the condition - the spinning, rocking and repetitive behavior.
New gene linked to autism risk, especially in boys
UCLA scientists have discovered a variant of a gene called CACNA1G that may increase a child's risk of developing autism, particularly in boys.
Autism in the UK costs more than $41 billion every year, shows new research
Research published this week in the Journal Autism, published by SAGE, estimate the annual costs of autism spectrum disorder (ASD) to be more than £27 billion a year.
Research shows wide age gap between possible and actual autism diagnosis
"Timely identification and diagnosis of an autism spectrum disorder (ASD) can impact a child's development and is the key to opening the door to the services and therapies available to children with autism," says Paul Shattuck, Ph.D., assistant professor at the George Warren Brown School of Social Work at Washington University in St. Louis.
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