A naturalistic open-label study of mirtazapine in autistic and other pervasive d

October 23, 2001

J Child Adolesc Psychopharmacol 2001 Fall;11(3):267-77

A naturalistic open-label study of mirtazapine in autistic and other

pervasive developmental disorders.

Posey DJ, Guenin KD, Kohn AE, Swiezy NB, McDougle CJ.

Department of Psychiatry, Indiana University School of Medicine,

Indianapolis, USA.

OBJECTIVE: The aim of this study was to conduct a naturalistic, open-label

examination of the efficacy and tolerability of mirtazapine (a medication

with both serotonergic and noradrenergic properties) in the treatment of

associated symptoms of autism and other pervasive developmental disorders

(PDDs). METHODS: Twenty-six subjects (5 females, 21 males; ages 3.8 to 23.5

years; mean age 10.1 +/- 4.8 years) with PDDs (20 with autistic disorder, 1

with Asperger's disorder, 1 with Rett's disorder, and 4 with PDDs not

otherwise specified were treated with open-label mirtazapine (dose range,

7.5-45 mg daily; mean 30.3 +/- 12.6 mg daily). Twenty had comorbid mental

retardation, and 17 were taking concomitant psychotropic medications. At

endpoint, subjects' primary caregivers were interviewed using the Clinical

Global Impressions (CGI) scale, the Aberrant Behavior Checklist, and a

side-effect checklist. RESULTS: Twenty-five of 26 subjects completed at

least

4 weeks of treatment (mean 150 +/- 103 days). Nine of 26 subjects (34.6%)

were judged responders ( " much improved " or " very much improved " on the CGI)

based on improvement in a variety of symptoms including aggression,

self-injury, irritability, hyperactivity, anxiety, depression, and insomnia.

Mirtazapine did not improve core symptoms of social or communication

impairment. Adverse effects were minimal and included increased appetite,

irritability, and transient sedation. CONCLUSIONS: Mirtazapine was well

tolerated but showed only modest effectiveness for treating the associated

symptoms of autistic disorder and other PDDs.

PMID: 11642476 [PubMed - in process]

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