Citalopram efficacy study; interstitial 15q11‐q13 duplication mouse
摘要
Both articles reviewed in this issue are long-anticipated studies that have led to unexpected results. In many ways, unexpected results may teach us more in the long run, but only if we look at them in depth and in the context of previous research. Medications have mechanisms of action that account for their therapeutic effects and other mechanisms that contribute to side effects. The potency of a drug is related to how low the concentration of the compound is that leads to a maximal effect. A full effect with low concentration is referred to as high potency. Medications with moderate potency for blocking the serotonin transporter are effective treatments for anxiety disorders and depression in the absence of ASDs. However, only medications with high potency for blocking reuptake of serotonin through the serotonin transporter have demonstrated efficacy for treating obsessive-compulsive disorder (in the absence of documented ASD). Examples of potent serotonin reuptake inhibitors are clomipramine, fluoxetine, sertraline, fluvoxamine, paroxetine, citalopram, and escitalopram. All of these medications, except clomipramine, are considered selective serotonin reuptake inhibitors (SSRIs). SSRIs have fewer side effects than less selective medications such as clomipramine because they do not have moderate or greater potency drug effects independent of serotonin reuptake inhibition. Clomipramine has the same therapeutic mechanism of action on OCD, but additional side effects. The point of this long introduction is that clomipramine has the same therapeutic mechanism of action of SSRIs and studies demonstrating efficacy of clomipramine in ASDs are relevant to discussion of the study of citalopram in ASD being reviewed. The first controlled study of a medication with potent serotonin reuptake inhibition, clomipramine, was a randomized double-blind placebo controlled crossover study of 24 subjects compared to either placebo or desipramine [Gordon et al., 1993]. Clomipramine has