Autism Clinical Trial
Official title:
A Double-Blind Placebo-Controlled Randomized Clinical Trial of Fluvoxamine and Sertraline in Childhood Autism - Does SSRI Therapy Improve Behaviour and/or Mood?
The purpose of this study is to determine if fluvoxamine or sertraline reduce the fequency or severity of aggressive behaviour, obsessive symptoms, or anxiety in young children with autism. The within-patient variability in this patient population using standard neuropsychological instruments will also be determined and a predictor model for SSRI responsitivity based on baseline neuropsychological testing will be developed.
Autism is a neuropsychiatric disorder diagnosed in early childhood. Approximately 10
Canadian children per 10 000 live births suffer from the disorder, which is three to four
times more common in males than in females. It is characterized by social and and
communicative deficits and restricted, repetitive interests and behaviours. Most autistic
children are delayed in the acquisition of both verbal and non-verbal communication skills
and many never develop useful language. Three-quarters of autistic children have mild to
severe mental retardation and a quarter develop seizures during later childhood or
adolescence. Its etiology is heterogenous and there is no cure. Although behaviour therapy
is an important tool in management, pharmacotherapy remains a necessity for many children.
Current therapy is limited to antipsychotic drugs that can carry an unacceptable risk of
chronic neurotoxicity (tardive dyskinesia) or tricyclic antidepressants that have
undesireble cardiovascular effects. This study proposes to evaluate the potential benefit of
selective seratonin reuptake inhibitors (SSRIs) in autism.
All autistic children whose symptoms are not currently well controlled will be offered entry
into the trial. Each child will randomized to eight weeks of fluvooxamine, sertraline, or
placebo. If they do not improve on their initial dose, they may have a dose increase and
continue in the study for a further eight weeks. Due to the significant amount of within-
and between- patient variability, multiple baseline evaluations will be completed prior to
the initiation of drug therapy. Parents may choose to continue therapy that was effective
for their child; if their child was randomized to placebo, parents may choose to try an SSRI
for a period of 8 weeks to assess effectiveness.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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