Use of Citalopram in Pervasive Developmental Disorders Namerow LB,
Thomas P, Bostic JQ, Prince J, Monuteaux MC Abstract: J Dev Behav Pediatr. 2003 Apr;24(2):104-8.
Findings A class of drugs called selective serotonin
re-uptake inhibitors (SSRIs), traditionally prescribed for depression,
have also shown to significantly improve symptoms associated with pervasive
developmental disorders (PDDs) such as autism and Asperger’s syndrome.
In the nerve cell, serotonin functions
to send messages to help regulate mood—in some people, there is
a lack of this neurotransmitter, and SSRIs
inhibit their re-uptake and destruction, thereby increasing the levels
in the nerve cell. Numerous studies have suggested benefits of SSRIs in
treating PDDs. Dr. Namerow and her colleages studied the medical
charts of 15 children and adolescents (aged 6-16 years) with Asperger
syndrome, autism or PDD not otherwise specified (PDD-NOS) who were treated
with citalopram, a new SSRI drug. All individuals were clinically diagnosed
with PDDs, and were at least moderately to severely impaired by their
symptoms. The patients had been treated for a mean period of 218.8 ±
167 days at a mean citalopram dose of 16.9 ± 12 mg/day. The investigators
rated improvement in PDD symptoms before drug (baseline) and at last visit
using the Clinical Global Impression (CGI) Severity and improvement scale. Eleven adolescents (73%) showed significant improvement in PDD symptoms, anxiety, or mood. Anxiety associated with PDDs improved significantly in 66% of patients, and mood improved significantly in 47% of patients. Five patients (33%) reported mild side effects such as headache, sedation, agitation, none of which were severe enough to be removed from the medication. Conclusions This study was a retrospective study with only a small number of PDD outpatients, and the data cannot be generalized to other PDD populations. Also, unlike many drug trials that are double-blind and placebo controlled, this was an open review of patients. Some patients were taking concurrent medications and were being treated by a professional therapist, which could have influenced the results. Also, measurement of PDD symptoms vary, and other symptoms not measured could have been affected. Despite these limitations, this study showed that citalopram given in proper recommended dosages may be safe and well tolerated in treating children and adolescents with PDDs. The authors state that “citalopram may also be appropriate for children and adolescents who have not responded adequatetly to other SSRI drugs, and particularly for targeting symptoms overlapping with obsessive-compuslive disorder, other anxiety disorders, or other mood disorders.” Controlled studies with larger numbers of children and adolscents with PDDs are necessary to more conclusively determine the efficacy and safety of this drug in treating PDD symptoms. |