Autism and Obsessive-Compulsive Spectrum Program, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, USA.
Am J Psychiatry. 2012 Mar;169(3):292-9. doi: 10.1176/appi.ajp.2011.10050764.
The effects of fluoxetine and placebo on repetitive behaviors and global severity were compared in adults with autism spectrum disorders (ASDs).
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.
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.
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.
比较氟西汀和安慰剂对自闭症谱系障碍（ASD）成人重复行为和整体严重程度的影响。
ASD 成人参加了一项为期 12 周的双盲安慰剂对照氟西汀试验。37 人随机分为氟西汀组（N=22）或安慰剂组（N=15）。剂量遵循固定方案，从 10mg/天开始，根据耐受情况增加至 80mg/天。重复行为使用耶鲁-布朗强迫症量表的强迫分量表进行测量；使用临床总体印象（CGI）改善量表来评定强迫症症状和总体严重程度的改善。
存在治疗与时间的显著交互作用，表明氟西汀组的重复行为随时间显著减少，而安慰剂组则无显著减少。根据 CGI 总改善评分 2 或更低定义为整体反应，氟西汀组在第 12 周的反应者明显多于安慰剂组。CGI 总体改善的风险比为 1.5（反应者：氟西汀，35%；安慰剂，0%），CGI 评定的强迫症症状改善的风险比为 1.8（反应者：氟西汀，50%；安慰剂，8%）。仅观察到轻度和中度副作用。
与安慰剂相比，氟西汀治疗在耶鲁-布朗强迫分量表和 CGI 评定的强迫症症状改善以及 CGI 总体改善评定方面，均显著改善了重复行为，氟西汀似乎耐受性良好。这些发现与儿童自闭症西酞普兰试验的结果形成对比。
