?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=A+controlled+crossover+trial+of+fendluramine+in+autism&rft.creator=Stern%2C+L.M.&rft.creator=Walker%2C+M.K.&rft.creator=Sawyer%2C+M.G.&rft.creator=Oades%2C+R.D.&rft.creator=Badcock%2C+N.R.&rft.creator=Spence%2C+J.G.&rft.subject=Clinical+Psychology&rft.subject=Neuropsychiatry&rft.description=Introduction%3A+Against+a+background+of+variable+results+achieved+by+the+treatment+of+childhood+autism+with+dopaminergic+agonists+or+antagonists%2C+and+opiate+antagonists+and+mild+behavioural+improvements+achieved+following+treatment+with+fenfluramine+(Geller+et+al.%2C+1982%3B+Ritvo+et+al.%2C+1984+among+others)+a+12+month+double-blind+crossover+trial+of+fenfluramine+was+undertaken.+%5Bthe+d-isomer+releases+serotonin%2C+the+l-isomer+modestly+blocks+dopamine+receptors.%5D+%0A%0AMethods%3A+Six+female+and+14+male+children+and+adolescents+with+autism+were+enrolled+(median+9y%3B+range+5-17+years+of+age)+in+a+trial+run+over+a+1+month+baseline%2C+5+months+of+treatment%2C+2+months+placebo%2C+and+5+months+of+treatment.+Parent+diaries+were+kept.+Various+tests+and+rating+scales+for+development%2C+verbal+and+noverbal+abilities+along+with+measures+of+blood+serotonin%2C+urinary+catecholamines+and+auditory+event-related+potentials+(ERPs)+were+measured+at+6-month+intervals.%0A%0AResults%3A+%0Aa)+With+fenfluramine+treatment+children+lost+weight%2C+blood+serotonin+decreased+by+60%25+and+urinary+catecholamine+levels+fell+(25-45%25%2C+but+dopamine+utilization+(HVA%2FDA)+increased+2-4-fold.+%0Ab)+Under+fenfluramine+some+autistic+subjects+improved+on+measures+of+cognitive+and+language+function.+Two+mute+subjects+began+to+speak%2C+but+for+the+group+overall+the+improvements+did+not+prove+significant.+%5BBritish+Ability+Scale%2C+Reynell+developmental+language+and+Vineland+social+maturity+scale+improvements+were+significant.%5D%0Ac)+Treatment+improved+early+stages+of+information+processing%2C+but+impaired+later+stages+as+measured+in+the+ERP+(i.e.+early+negative+going+excitatory+vs.+later+positive+going+inhibitory+response%2C+respectively+in+7+patients).+The+early+negativity+changes+(especially+over+the+right+hemisphere)+correlated+inversely+with+HVA%2FDA+actvivity.%0Ad)+Side+effects+reported+included+lethargy+and+irritability..+%0A%0A%0AConclusions%3A+While+individuals+showed+marked+reductions+of+stereotypies%2C+hyperactivity%2C+and+improvements+on+develepmental+and+cognitive+measures%2C+the+absence+of+clear+group-wide+effects+suggests+that+fenfluramine+would+have+but+a+limited+place+in+the+management+of+some+patients+with+autism.%0A%0A&rft.publisher=Pergamon+Press+plc&rft.date=1990&rft.type=Journal+(Paginated)&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.identifier=http%3A%2F%2Fcogprints.org%2F1354%2F2%2FAut-Fen-1990.pdf&rft.identifier=++Stern%2C+L.M.+and+Walker%2C+M.K.+and+Sawyer%2C+M.G.+and+Oades%2C+R.D.+and+Badcock%2C+N.R.+and+Spence%2C+J.G.++(1990)+A+controlled+crossover+trial+of+fendluramine+in+autism.++%5BJournal+(Paginated)%5D+++++&rft.relation=http%3A%2F%2Fcogprints.org%2F1354%2F