Retrial of selective serotonin reuptake inhibitors in children with pervasive developmental disorders: a retrospective chart review.
BACKGROUND
Youths with pervasive developmental disorders (PDDs) often have symptoms that fail to respond to selective serotonin reuptake inhibitor (SSRI) treatment. These children may be given a subsequent trial of another SSRI. This study reports on the outcome of PDD youths who received a second SSRI trial after an initial treatment failure.


METHODS
Clinic charts were reviewed for 22 outpatient youths with a DSM-IV diagnosis of a PDD who were treated with an SSRI after an initial failure with a previous SSRI. Response for the second SSRI trial was determined using the Clinical Global Impressions-Improvement Scale (CGI-I). Treatment indications, symptom severity, demographic data, and side effects were recorded.


RESULTS
For the second SSRI trial, 31.8% of the subjects were rated as much improved on the CGI-I scale and determined to be responders, with 68.2% of the subjects demonstrating activation side effects. 90% of subjects demonstrated activation side effects when data from both SSRI trials were combined. There were no statistically significant associations between outcome of the second SSRI trial and clinical/demographic variables.


CONCLUSIONS
A second trial of an SSRI after an initial SSRI treatment failure was often unsuccessful in children and adolescents with PDDs. Activation side effects were common. Because alternative treatments in this population are limited, a second trial of an SSRI may still be considered. The study was limited by its retrospective design and by its small sample size.
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. charles_henry@hms.harvard.edu
Charles A
CA
Henry
David
D
Shervin
Ann
A
Neumeyer
Ronald
R
Steingard
Jessaca
J
Spybrook
Roula
R
Choueiri
Margaret
M
Bauman
D000293:Adolescent; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D017211:Treatment Failure
D017367:Selective Serotonin Reuptake Inhibitors