{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:44:13Z","timestamp":1793609053629,"version":"4.5.0"},"reference-count":49,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec id=\"S2056472421010036_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472421010036_sec_a2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We carried out a systematic review and meta-analysis of randomised controlled trials that assessed the effectiveness of these medications in people with ASD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472421010036_sec_a3\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472421010036_sec_a4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472421010036_sec_a5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2021.1003","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T03:05:23Z","timestamp":1633057523000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":51,"title":["Randomised controlled trials of antidepressant and anti-anxiety medications for people with autism spectrum disorder: systematic review and meta-analysis"],"prefix":"10.1192","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1300-8103","authenticated-orcid":false,"given":"Shoumitro","family":"Deb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madiha","family":"Majid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharati","family":"Limbu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Santambrogio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8432-981X","authenticated-orcid":false,"given":"Ashok","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco O.","family":"Bertelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"key":"S2056472421010036_ref13","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.0 (Updated July 2019)","author":"Lefebvre","year":"2019"},{"key":"S2056472421010036_ref32","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00810"},{"key":"S2056472421010036_ref9","article-title":"Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD)","volume":"8","author":"Williams","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"S2056472421010036_ref34","doi-asserted-by":"publisher","DOI":"10.2217\/14750708.1.1.87"},{"key":"S2056472421010036_ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-005-3305-2"},{"key":"S2056472421010036_ref8","article-title":"Tricyclic antidepressants for autism spectrum disorders (ASD) in children and adolescents","volume":"3","author":"Hurwitz","year":"2012","journal-title":"Cochrane Database of Syst Rev"},{"key":"S2056472421010036_ref11","volume-title":"Guidance Notes for Registering a Systematic Review Protocol with PROSPERO","year":"2016"},{"key":"S2056472421010036_ref29","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.14685"},{"key":"S2056472421010036_ref25","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-200108000-00012"},{"key":"S2056472421010036_ref27","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300627"},{"key":"S2056472421010036_ref2","volume-title":"International Classification of Diseases for Mortality and Morbidity Statistics (11th Revision)","year":"2019"},{"key":"S2056472421010036_ref45","volume-title":"The Repetitive Behavior Scale","author":"Bodfish","year":"1999"},{"key":"S2056472421010036_ref46","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1983.01790100074010"},{"key":"S2056472421010036_ref35","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.1 (Updated September 2020)","author":"Higgins","year":"2020"},{"key":"S2056472421010036_ref43","first-page":"839","article-title":"CGI (Clinical Global Impression Scale)\u2013NIMH","volume":"21","year":"1985","journal-title":"Psychopharmacol Bull"},{"key":"S2056472421010036_ref24","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1993.01820180039004"},{"key":"S2056472421010036_ref18","unstructured":"18 Mendeley. 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