Therapies for Children With Autism Spectrum Disorders

Evidence Table. Therapies for children with ASD
Study
Inclusion/Exclusion Baseline
Description Intervention
Criteria/Population Measures Outcomes
Author:
Intervention:
Inclusion criteria: Overall ratings: Overall ratings:
Henry et al., 2006 Subjects treated with an • Age 18 or younger CGI-S score, mean CGI-I score, mean
Country:
US
Practice
setting:
Academic
Intervention
setting:
Clinic (neurodevelopmental)
Enrollment
period:
July 2001 to
January 2004
Funding:
NR
Author industry
relationship
disclosures:
None
Design:
Retrospective
case series
SSRI:*
• DSM-IV diagnosis of ± SD:
SSRI, n (%):
autism, Asperger G1: 4.55 ± 0.71
Sertraline: 31 (34.8) disorder or PDD-NOS
Citalopram: 25 (28.1) • Subjects treated with an
Paroxetine: 15 (16.9) SSRI
Fluvoxamine: 10 (11.2) Exclusion criteria:
Fluoxetine: 6 (6.7) • See inclusion criteria
Escitalopram: 2 (2.2) Age, years ± SD (range):
Mean dose, mg (SE): 8.6 ± 3.4 (3-18)
Sertraline: 46.7 (47.54) Mental age:
Citalopram:10.42 (6.77) NR
Paroxetine: 10.67 (4.95) Gender, n (%):
Fluvoxamine: 40.28 Male: 80 (90)
(33.53)
Female: 9 (10)
Fluoxetine: 18.33 (14.50) Race/ethnicity:
Escitalopram:11.25 NR
(12.37)
SES:
Treatment duration was Maternal education: NR
7.8 ± 7.6 months Household income: NR
Assessments:
Diagnostic approach:
Diagnosis using DSM-IV, Referral
parental interview, child Diagnostic tool/method:
exam, record review by DSM-IV-chart review
trained child and Diagnostic category, n
adolescent psychiatrists (%):
SCI-I and CGI-S scales Autism: 50 (56)
completed by reviewers PDD-NOS: 33 (37)
Groups:
Aspergers: 6 (7)
G1: PDD subjects treated Other characteristics:
with SSRIs
Comorbid Diagnoses, n:
Co-interventions held ADHD-NOS: 5
stable during treatment: Mental retardation: 4
NR
Anxiety disorder NOS: 3
Frequency of contact Mood disorder NOS: 3
during study:
Oppositional-defiant
NA
disorder: 3
Concomitant therapies, Adjustment disorder: 1
n :
PTSD: 1
Alpha-2 agonists: 22 Cleft lip: 1
Psychostimulants: 20 Central hypomyleination: 1
Atypical antipsychotics: Complex II mitochondrial
15
disorder: 1
Mood stabilizers: 3 Seizure disorder: 1
Atomoxetine: 6
Hypotonia/hypermobility: 1
Gabapentin: 3
Lead poisoning: 1
Bupropion: 2
± SD:
G1: 2.93 ± 1.11
Trial outcome, n
(%):
Much or very
much improved:
40/89 (44.9)
Worsened: 9/89
(10.1)
Failed trial due to
AEs or lack of
efficacy: 28/89
(31.5)
Lost to outside
follow-up: 16/89
(18)
Drop out, reason
unknown: 3/89
(3.4)
Response rate by
SSRI, %:
Sertraline: 55
Citalopram: 44
Paroxetine: 53
Fluvoxamine: 30
Fluoxetine: 0
Escitalopram: 50
(P = 0.19)
Response rate by
indication, %:
Anxiety: 48
Perseverations:
44
Aggression: 45
Depressed mood:
60
(P = 0.86)
Response rate by
diagnosis, %:
Autism: 46
Asperger
disorder: 33
PDD-NOS: 46
(P = 0.84)
Response rate by
family history, %
Buspirone: 2
(P-value for
Lorazepam: 1
correlation with
Phenytoin: 1
positive outcome):
Levothyroxine: 1
PDDs: 72
(P = 0.011)**
C-276