Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
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Retrospective Analyses of Long-Term Use of SSRI in Children and Adolescents with Autism Spectrum Disorder

소아청소년 자폐성 스펙트럼 장애에서 SSRI 장기 사용에 대한 후향적 분석

  • Goo, Ae-Jin (Department of Mental Health, Seoul National Hospital) ;
  • Park, Jin-Park (Department of Mental Health, Seoul National Hospital) ;
  • Lee, Jong-Il (Department of Mental Health, Seoul National Hospital) ;
  • Jhin, Hye-Kyung (Institute of Child and Adolescent Psychiatry, LPJ Mind Health Clinic) ;
  • Kim, Yeni (Department of Adolescent Psychiatry, Seoul National Hospital)
  • 구애진 (국립서울병원 정신건강의학과) ;
  • 박진박 (국립서울병원 정신건강의학과) ;
  • 이종일 (국립서울병원 정신건강의학과) ;
  • 진혜경 (LPJ 마음건강의원 소아청소년연구소) ;
  • 김예니 (국립서울병원 청소년정신건강의학과)
  • Received : 2012.08.01
  • Accepted : 2012.09.07
  • Published : 2012.11.30
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Abstract

Objectives The purpose of this study was to investigate clinical profile, efficacy, and safety of long-term treatment with selective serotonin reuptake inhibitors (SSRIs) in Korean autism spectrum disorders (ASDs) patients. Methods Effectiveness was assessed through a retrospective review of self-reported target symptom improvement at the last follow-up visit. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity (CGI-S) of illness and Clinical Global Impression-Improvement (CGI-I) Scales. Tolerability was assessed through a review of the reason for discontinuation of SSRI and documented adverse events. Results A total of 21 ASDs patients (aged 9 to 19 years) treated with SSRI during July 2010 to July 2011 in department of child and adolescent psychiatry of Seoul National Hospital were identified. The mean duration of SSRI treatment was 47.9 (standard deviation = 36.9) months (range 0.7-114.5), and the mean fluoxetine equivalent dosage of SSRIs was $27.1{\pm}10.8$ mg. Nineteen (90.5%) patients were using concomitant medication. We found that SSRIs were prescribed for symptoms of agitation, stereotyped behavior, aggression, depression, impulsivity and self-injury in ASDs. Ten patients (47.6%) reported improvement in their target symptom after SSRI treatment based on CGI-I scores (CGI-I ${\leq}$ 2). The side effects were reported in 5 patients (23.8%) ; vomiting (n = 2, 9.5%), excessive mood elevation (n = 1, 4.8%), insomnia (n = 1, 4.8%), somnolence (n = 1, 4.8%) and decreased appetite (n = 1, 4.8%). Self-injurious behavior was reported in one patient (4.8%). Conclusions The results of this study suggest that SSRIs may be used effectively in children and adolescents diagnosed with ASDs. However, safety issues need to be considered carefully when choosing SSRIs for treatment. Future controlled trials are needed to confirm these findings.

Keywords

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