A double-blind comparison of clomipramine, desipramine, and placebo in the treatment of autistic disorder

Arch Gen Psychiatry. 1993 Jun;50(6):441-7. doi: 10.1001/archpsyc.1993.01820180039004.


Objective: To determine whether clomipramine hydrochloride, a serotonin reuptake blocker with unique anti-obsessional properties, is differentially effective for obsessive-compulsive and stereotyped motor behaviors in autistic disorder compared with placebo and with the noradrenergic tricyclic antidepressant agent, desipramine hydrochloride.

Design: Following a 2-week, single-blind placebo washout phase, 12 autistic subjects completed a 10-week, double-blind, crossover comparison of clomipramine and placebo, and 12 different subjects completed a similar comparison of clomipramine and desipramine.

Setting: Outpatient clinic.

Patients: A referral sample of 30 male and female autistic patients were enrolled, and 24 completed the study.

Measures: Key outcome measures were the Autism Relevant Subscale of the Children's Psychiatric Rating Scale, the Modified Comprehensive Psychopathological Rating Scale-Obsessive-Compulsive Disorder Subscale, and the Clinical Global Impressions Scale.

Results: Clomipramine was superior to both placebo and desipramine on ratings of autistic symptoms (including stereotypies), anger, and compulsive, ritualized behaviors (P < .05), with no differences between desipramine and placebo. Clomipramine was equal to desipramine and both tricyclic agents were superior to placebo for amelioration of hyperactivity.

Conclusion: Biological links between compulsions and stereotyped, repetitive behaviors in autistic disorder should be explored.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care
  • Autistic Disorder / diagnosis
  • Autistic Disorder / drug therapy*
  • Autistic Disorder / psychology
  • Child
  • Clomipramine / therapeutic use*
  • Desipramine / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / drug therapy*
  • Obsessive-Compulsive Disorder / psychology
  • Placebos
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Stereotyped Behavior / drug effects
  • Treatment Outcome


  • Placebos
  • Clomipramine
  • Desipramine