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Deb S, Roy M, Lee R, et al. Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder: systematic review and meta-analysis. BJPsych Open. 2021;7(6):e179doi: 10.1192/bjo.2021.1003.
Deb, S., Roy, M., Lee, R., Majid, M., Limbu, B., Santambrogio, J., Roy, A., & Bertelli, M. 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. https://doi.org/10.1192/bjo.2021.1003
Deb, Shoumitro, et al. "Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder: systematic review and meta-analysis." BJPsych open vol. 7,6 (2021): e179. doi: https://doi.org/10.1192/bjo.2021.1003
Deb S, Roy M, Lee R, Majid M, Limbu B, Santambrogio J, Roy A, Bertelli MO. Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder: systematic review and meta-analysis. BJPsych Open. 2021 Oct 01;7(6):e179. doi: 10.1192/bjo.2021.1003. PMID: 34593083; PMCID: PMC8503912.
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BJPsych Open. 2021 Oct 01;7(6):e179. doi: 10.1192/bjo.2021.1003.

Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder: systematic review and meta-analysis.

BJPsych open

Shoumitro Deb, Meera Roy, Rachel Lee, Madiha Majid, Bharati Limbu, Jacopo Santambrogio, Ashok Roy, Marco O Bertelli

Affiliations

  1. Department of Brain Sciences, Faculty of Medicine, Imperial College London, UK.
  2. Department of Psychiatry, Hereford and Worcestershire Health and Care NHS Trust, UK.
  3. Department of Learning Disabilities, Coventry and Warwickshire Partnership NHS Foundation Trust, UK.
  4. Warwick Medical School, University of Warwick, UK.
  5. Clinical Neuroscience PhD program, Department of Medicine and Surgery, University of Milano-Bicocca, Italy.
  6. Research and Clinical Centre, San Sebastiano Foundation of the Misericordia of Florence, Italy.

PMID: 34593083 PMCID: PMC8503912 DOI: 10.1192/bjo.2021.1003

Abstract

BACKGROUND: 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.

AIMS: We carried out a systematic review and meta-analysis of randomised controlled trials that assessed the effectiveness of these medications in people with ASD.

METHOD: 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.

RESULTS: 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.

CONCLUSIONS: 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.

Keywords: Autism spectrum disorder; anti-anxiety medications; antidepressants; meta-analysis; systematic review

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