TREATMENT OF ELECTIVE MUTISM WITH FLUOXETINE - A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

Objective: To evaluate the efficacy of treatment with fluoxetine in re ducing symptoms associated with elective mutism. Method: Sixteen subje cts with elective mutism were treated with placebo (single-blind) for 2 weeks. Fifteen placebo nonresponders were then randomly assigned to double-blind treatment with fluoxetine at a dose of 0.6 mg/kg/day (N = 6) or continued placebo (N = 9) for an additional 12 weeks. Outcome r atings were completed by the treating psychiatrist, parents, and teach ers. Results: Significant improvements over time on ratings of electiv e mutism, anxiety, and social anxiety, rated by clinician, parents, an d teachers, were demonstrated in both fluoxetine- and placebo-treated subjects. Subjects treated with fluoxetine were significantly more imp roved than placebo-treated subjects on parent's ratings of mutism chan ge and global change. Clinician and teacher ratings did not reveal sig nificant differences between treatment groups. Although improved, most subjects in both treatment groups remained very symptomatic at the en d of the study period. Side effects were minimal. Conclusion: Fluoxeti ne may be beneficial and safe in the treatment of children with electi ve mutism. Longer periods of treatment may yield more substantial ther apeutic benefits. Further study is indicated.