Low-dose fluvoxamine treatment of children and adolescents with pervasive developmental disorders: a prospective, open-label study.
Low-dose fluvoxamine can help some kids with PDDs—especially girls—but group data say most will not change and a few will feel worse.
01Research in Context
What this study did
Doctors gave 18 kids and teens with pervasive developmental disorders a small daily dose of fluvoxamine for eight weeks.
They watched for any change in behavior and wrote down who got better, who got worse, and who had side effects.
What they found
As a group, the kids did not improve, but eight of the 18—every girl in the sample—did show some gain.
Three children had to quit early because the drug made them more restless or upset.
How this fits with other research
Hudson et al. (2012) looked at 33 drug trials in autism and found only a few medicines have solid proof; fluvoxamine was not one of them.
Bhatti et al. (2013) tried low-dose amitriptyline in 50 youths and saw 60% improve, a brighter picture than the mixed result here.
The difference may be the drug: amitriptyline hits sleep and hyperactivity hard, while fluvoxamine targets repetitive thoughts that are harder to see.
Laugeson et al. (2014) tested acamprosate in nine kids and saw six get better; like this study, the sample was tiny and uncontrolled, so both findings need a real trial before you bank on them.
Why it matters
If you have a girl with ASD who is stuck in rigid routines, a low-dose SSRI trial might be worth a talk with the prescriber, but watch for agitation in the first two weeks. Start small, track daily, and stop fast if behavior spikes.
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02At a glance
03Original abstract
The objective of this study was to assess the efficacy and tolerability of low-dose fluvoxamine (1.5 mg/kg/day) in youngsters with pervasive developmental disorders (PDDs). This was a prospective, open-label trial that included 18 subjects with a mean age of 11.3 +/- 3.6 years. Fourteen children (78%) completed the 10-week study. Premature discontinuation due to behavioral activation occurred in three participants. Although there was no response for the group as a whole, eight subjects (including all four females) were considered at least partial responders in intent-to-treat analyses. Neither pubertal status nor serotonin levels predicted clinical response. Fluvoxamine can be beneficial in the treatment of select children and adolescents with PDDs. Gender differences in selective serotonin reuptake inhibitor (SSRI) response warrant further investigation.
Journal of autism and developmental disorders, 2003 · doi:10.1023/a:1022234605695