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Objective: To assess the effect of escitalopram in the treatment of pervasive developmental disorders (PDDs).

Method: This 10-week study had a forced titration, open-label design. Twenty-eight subjects (mean age 125.1 /- 33.5 months) with a PDD received escitalopram at a dose that increased weekly to a maximum dose of 20 mg as tolerated. The Aberrant Behavior Checklist-Community Version (ABC-CV) and the Clinical Global Impression scale (CGI) were used to assess outcome.

Results: There was significant improvement in ABC-CV Irritability Subscale Scores (baseline mean 20.5 /- 5.9 to final mean 10.9 /- 7.2; p <= .001) and in the other ABC-CV Subscales. Improvement on Clinical Global Improvement Scale severity rating was also significant (baseline mean 5.2 /- 1.0 to final mean 4.6 /- 1.2; p <= .001). Twenty-five percent of the subjects responded at a dose less than 10 mg and did not tolerate the 10-mg dose, and an additional 36% responded at a dose greater than or equal to 10 mg. Final dose was unrelated to weight and only weakly correlated with age.

Conclusions: This open-label study found escitalopram to be useful in treating some difficulties common in PDDs. A wide variability in dose was found that could not be accounted for by weight and only partially by age. The study provides information useful for the design of double-blind, placebo-controlled studies of escitalopram in PDDs.

Copyright 2005 (C) American Academy of Child and Adolescent Psychiatry