title: A double-blind placebo-controlled trial of fluoxetine for repetitive behaviors and global severity in adult autism spectrum disorders.
abstract: OBJECTIVE
  The effects of fluoxetine and placebo on repetitive behaviors and global severity were compared in adults with autism spectrum disorders (ASDs).
  
  
  METHODS
  Adults with ASDs were enrolled in a 12-week double-blind placebo-controlled fluoxetine trial. Thirty-seven were randomly assigned to fluoxetine (N=22) or placebo (N=15). Dosage followed a fixed schedule, starting at 10 mg/day and increasing as tolerated up to 80 mg/day. Repetitive behaviors were measured with the compulsion subscale of the Yale-Brown Obsessive Compulsive Scale; the Clinical Global Impression (CGI) improvement scale was used to rate improvement in obsessive-compulsive symptoms and overall severity.
  
  
  RESULTS
  There was a significant treatment-by-time interaction indicating a significantly greater reduction in repetitive behaviors across time for fluoxetine than for placebo. With overall response defined as a CGI global improvement score of 2 or less, there were significantly more responders at week 12 in the fluoxetine group than in the placebo group. The risk ratio was 1.5 for CGI global improvement (responders: fluoxetine, 35%; placebo, 0%) and 1.8 for CGI-rated improvement in obsessive-compulsive symptoms (responders: fluoxetine, 50%; placebo, 8%). Only mild and moderate side effects were observed.
  
  
  CONCLUSIONS
  Fluoxetine treatment, compared to placebo, resulted in significantly greater improvement in repetitive behaviors, according to both the Yale-Brown compulsion subscale and CGI rating of obsessive-compulsive symptoms, as well as on the CGI overall improvement rating. Fluoxetine appeared to be well tolerated. These findings stand in contrast to findings in a trial of citalopram for childhood autism.
authors.affiliation: Autism and Obsessive-Compulsive Spectrum Program, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, USA. eholland@montefiore.org
authors.forename: Eric
authors.initials: E
authors.lastname: Hollander
authors.forename: Latha
authors.initials: L
authors.lastname: Soorya
authors.forename: William
authors.initials: W
authors.lastname: Chaplin
authors.forename: Evdokia
authors.initials: E
authors.lastname: Anagnostou
authors.forename: Bonnie P
authors.initials: BP
authors.lastname: Taylor
authors.forename: Casara J
authors.initials: CJ
authors.lastname: Ferretti
authors.forename: Stacey
authors.initials: S
authors.lastname: Wasserman
authors.forename: Erika
authors.initials: E
authors.lastname: Swanson
authors.forename: Cara
authors.initials: C
authors.lastname: Settipani
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009770:Obsessive Behavior / Q000188:drug therapy; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D019956:Stereotypic Movement Disorder / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors