Fluoxetine treatment of selective mutism in pervasive developmental disorder

Abstract

We report the successful treatment of selective mutism in a child with pervasive developmental disorder (PDD). There are several studies and case reports in which Fluoxetine has been reported effective in diminishing adult social anxiety and increasing speech in public settings. The literature is much smaller for children. The efficacy of fluoxetine supports the argument that selective mutism is a developmental equivalent of social anxiety disorder. To our knowledge this is the first description of successful treatment when the selective mutism is complicated by PDD.

Incorporating Technology Into the Treatment of a 17-Year-Old Female With Selective Mutism

“…The relationship between SM and social anxiety has been of particular interest to researchers and clinicians, and various theories have been postulated regarding their shared clinical presentation (see Viana et al, 2009, for a review). Specifically, SM may represent a developmental variant of social anxiety disorder (a disorder characterized by intense fear and avoidance of social interactions; APA, 2000; Bergman et al, 2002), as the two disorders are strikingly similar (Anstendig, 1999; Black & Uhde, 1992; Silveira, Jainer, & Bates, 2004). Children presenting with SM report being too afraid to speak in social situations (Black & Uhde, 1995; Dummit, Klein, Tancer, & Asche, 1997; Sharp, Sherman, & Gross, 2007; Vecchio & Kearney 2005) and may use withdrawal of speech as an avoidance mechanism (Young, Bunnell, & Beidel, 2012).…”

Managing anxiety comorbidity in youth with autism spectrum disorders

“…Basic guidelines for implementation of pharmacotherapy across varying anxiety disorders in youth with ASD have been put forth [52], but controlled research studies are few in number. Medications such as serotonin reuptake inhibitors, anxiolytics and benzodiazepines, among others, have shown preliminary promise in case series, open trials or retrospective chart reviews for reduction of various symptoms of anxiety (e.g., sertraline [53][54][55], buspirone [56]; fluoxetine [57] and citalopram [58]); however, the majority of studies, particularly those with pediatric populations, have methodological limitations, and reports of success with decreasing anxiety are mixed [2]. When targeting repetitive behaviors, citalopram was not significantly different from the placebo in a large cohort of youth with ASD [59].…”

Evaluation of Children With Selective Mutism and Social Phobia: A Comparison of Psychological and Psychophysiological Arousal

“…The most frequent explanation is that children with SM are socially anxious and thus do not speak in social settings (Black & Uhde, 1995; Dummit et al, 1997; Sharp, Sherman, & Gross, 2007; Vecchio & Kearney, 2005). Several common clinical features of social phobia (SP) and SM support the conceptualization that the two disorders are related, or even the same diagnostically (Anstendig, 1999; Black & Uhde, 1992; Silveira, Jainer, England, & Bates, 2004), with SM conceptualized as a developmental variant of SP (Bergman et al, 2002). For example, children with SM have elevated scores on self-report measures of social anxiety and shyness (Carbone et al, 2010; Cunningham, et al, 2004; Dummit et al, 1997; Steinhausen & Juzi, 1996).…”