Research: Lack of Efficacy of Citalopram in Children with Autism Spectrum Disorders and High Levels of Repetitive Behavior

Citalopram (Cilexa®) therapy may not be helpful for improving behaviors or skills in children with autism.

This article reports results of a large randomized, placebo-controlled, double-blind study of citalopram with 149 children (5-17 years old). The children had autism, Asperger syndrome, or pervasive developmental disorder not otherwise specified (PDD-NOS). All of the children had moderate to severe compulsive or repetitive behaviors. They received citalopram therapy (10-20 mg/day) or a placebo (sugar pill) for 12 weeks. Citalopram therapy did not reduce repetitive behaviors or improve any other behaviors more than the placebo did. The authors tested more than 11 behaviors and skills using 3 different standard tests. Side effects of the drug therapy included increased energy, impulsiveness, decreased concentration, hyperactivity, stereotypy, diarrhea, sleep problems, and dry skin. The authors said that higher doses of citalopram may improve behaviors, but would also lead to more side effects. A commentary by F.R. Volkmar in the same journal issue noted that this study was large and well-designed. He agreed that citalopram may not be helpful for children with autism.