Effect of fluoxetine on regional cerebral metabolism in autistic spectrum disorders: a pilot study.
The regional metabolic effects of fluoxetine were examined in patients with autism spectrum disorders. Six adult patients with DSM-IV and Autism Diagnostic Interview (ADI) diagnoses of autism (n = 5) and Asperger's syndrome (n = 1), entered a 16-wk placebo-controlled cross-over trial of fluoxetine. The patients received (18)F-deoxyglucose positron emission tomography with co-registered magnetic resonance imaging at baseline and at the end of the period of fluoxetine administration. After treatment, the patients showed significant improvement on the scores of the Yale--Brown Obsessive--Compulsive Scale -- Obsessions subscale and the Hamilton Anxiety Scale; Clinical Global Impressions -- Autism scores showed 3 of the patients much improved and 3 unchanged. Relative metabolic rates were significantly higher in the right frontal lobe following fluoxetine, especially in the anterior cingulate gyrus and the orbitofrontal cortex. Patients with higher metabolic rates in the medial frontal region and anterior cingulate when unmedicated were more likely to respond favourably to fluoxetine. These results are consistent with those in depression indicating that higher cingulate gyrus metabolic rates at baseline predict SRI response.
Buchsbaum
M S
MS
Neiroscience PET Laboratory, Mt. Sinai School of Medicine, New York, NY 10029-6574, USA. monte.buchsbaum@mssm.edu
Hollander
E
E
Haznedar
M M
MM
Tang
C
C
Spiegel-Cohen
J
J
Wei
T C
TC
Solimando
A
A
Buchsbaum
B R
BR
Robins
D
D
Bienstock
C
C
Cartwright
C
C
Mosovich
S
S
D000328:Adult; D000704:Analysis of Variance; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D020817:Asperger Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism*; D001321:Autistic Disorder / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism*; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D018592:Cross-Over Studies; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005625:Frontal Lobe / Q000378:metabolism; D006179:Gyrus Cinguli / Q000378:metabolism; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011877:Radionuclide Imaging; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors