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Objective: A pilot study was designed to evaluate the safety and efficacy of fluoxetine treatment for children with selective mutism (elective mutism in DSM-III-R).

Method: Twenty-one children (mean age 8.2 years, range 5 through 14) participated in a 9-week open trial of fluoxetine in graduated doses (mean end dose 28.1 mg, range 10 to 60 mg) with systematic baseline and outcome evaluations and weekly clinical assessment.

Results: All 21 children met DSM-III-R and DSM-IV criteria for anxiety disorders. After fluoxetine treatment, 76% were improved, with diminished anxiety and increased speech in public settings, including school. Improvement at week 9 was inversely correlated with age.

Conclusions: Persistent selective mutism presenting with comorbid anxiety disorders may respond to fluoxetine treatment.

Copyright 1996 (C) American Academy of Child and Adolescent Psychiatry