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Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder : systematic review and meta-analysis
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Deb, Shoumitro, Roy, Meera, Lee, Rachel, Majid, Madiha, Limbu, Bharati, Santambrogio, Jacopo, Roy, Ashok and Bertelli, Marco O. (2021) Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder : systematic review and meta-analysis. BJPsych Open, 7 (6). e179. doi:10.1192/bjo.2021.1003 ISSN 2056-4724.
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WRAP-randomised-controlled-trials-antidepressant-anti-anxiety-medications-autism-spectrum-disorder-meta-analysis.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-No Derivative Works 4.0. Download (664Kb) | Preview |
Official URL: https://doi.org/10.1192/bjo.2021.1003
Abstract
Although widely used, the current evidence for the efficacy of antidepressant and anti-anxiety medications for people with autism spectrum disorder (ASD) is limited and conflicting. We carried out a systematic review and meta-analysis of randomised controlled trials that assessed the effectiveness of these medications in people with ASD. We searched the following databases: Cochrane Library, Medline, EMBASE, CINAHL, PsycINFO, ERIC, DARE and ClinicalTrials.gov. Additionally, we hand-searched 11 relevant journals. We used the Cochrane risk-of-bias tool and Jadad score to assess the quality of each included study. We carried out a meta-analysis using a random effects model. We included 15 randomised controlled trials (13 on antidepressants and two on anti-anxiety medications) for a total of 958 people with ASD. Data showed contradictory findings among the studies, with larger studies mostly showing a non-significant difference in outcomes between the treatment and the placebo groups. Meta-analysis of pooled Yale-Brown Obsessive Compulsive Scale and Clinical Global Impression Scale data from nine studies (60%) did not show any statistically significant inter-group difference on either of the outcome measures. The adverse effects reported were mild and, in most studies, their rates did not show any significant inter-group difference. Given the methodological flaws in the most included studies and contradictory findings, it is difficult to draw any definitive conclusion about the effectiveness of either antidepressant or anti-anxiety medications to treat either ASD core symptoms or associated behaviours. Robust, large-scale, randomised controlled trials are needed to address this issue.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Library of Congress Subject Headings (LCSH): | Autism spectrum disorders -- Treatment -- Evaluation, Antidepressants, Anxiety disorders -- Treatment -- Evaluation, Meta-analysis | ||||||
Journal or Publication Title: | BJPsych Open | ||||||
Publisher: | Cambridge University Press | ||||||
ISSN: | 2056-4724 | ||||||
Official Date: | November 2021 | ||||||
Dates: |
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Volume: | 7 | ||||||
Number: | 6 | ||||||
Article Number: | e179 | ||||||
DOI: | 10.1192/bjo.2021.1003 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Re-use Statement: | ** From PubMed via Jisc Publications Router | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 20 October 2021 | ||||||
Date of first compliant Open Access: | 20 October 2021 | ||||||
RIOXX Funder/Project Grant: |
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