This paper is a systematic review and meta-analysis of the efficacy of available medications for the treatment of restricted/repetitive behavior (RRBs) in Autism Spectrum Disorder (ASD). We searched MEDLINE, Embase, PsycINFO, The Cochrane Library (Cochrane Database of Systematic Reviews (CDRS), the Cochrane Central Register of Controlled Trials (CENTRAL), database of Abstracts of Reviews of Effects (DARE)), Scopus, Epistimonikos, Clinicaltrials.gov, and included all randomized controlled trials published after 1993 that were directed at RRBs in patients with ASD of all ages. We extracted the relevant data from the published studies with a predefined data extraction form and assessed the risk of bias. The primary outcomes were change in restricted/repetitive behavior. We performed a meta-analysis using the random effect model and included studies with given mean and standard deviation. This study is registered with PROSPERO number CRD42018092660). We identified 14 randomized controlled trials that met initial inclusion criteria. After closer inspection, nine trials – involving 552 patients in total – were included in the final analysis. The meta-analysis found no significant difference between medications (including fluvoxamine, risperidone, fluoxetine, citalopram, oxytocin, N-Acetylcysteine, buspirone) and placebo in the treatment of RRBs in ASD (P = 0.20). Similarly, the sub-group meta-analysis also showed no significant difference between Selective Serotonin Reuptake Inhibitor (SSRIs) and placebo in the treatment of RRBs in ASD (P = 0.68). There was no evidence of publication bias. This meta-analysis finds little support for the routine use of medications to treat restricted/repetitive behaviors in Autism Spectrum Disorder. Further research of large, balanced trials with precise assessment tools and long-term follow-up are needed. The study protocol is registered in PROSPERO (Reference number: CRD42018092660).

中文翻译：

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自闭症谱系障碍的限制性/重复性行为的药物治疗：系统评价和荟萃分析。

本文是对现有药物治疗自闭症谱系障碍（ASD）的限制性/重复性行为（RRB）的功效的系统评价和荟萃分析。我们搜索了MEDLINE，Embase，PsycINFO，Cochrane库（系统评价的库克伦数据库（CDRS），对照试验的Cochrane中央登记册（CENTRAL），效果评价摘要数据库（DARE）），Scopus，Epistimonikos，Clinicaltrials。 gov，并包括1993年后发布的针对所有年龄段ASD患者的RRB的所有随机对照试验。我们以预定的数据提取形式从已发表的研究中提取了相关数据，并评估了偏倚风险。主要结果是限制/重复行为的改变。我们使用随机效应模型进行了荟萃分析，并纳入了具有给定均值和标准差的研究。该研究已在PROSPERO注册，编号为CRD42018092660。我们确定了14项符合初始入选标准的随机对照试验。经过仔细检查，最终分析包括9项试验，共552名患者。荟萃分析发现，在ASD的RRB治疗中，药物（包括氟伏沙明，利培酮，氟西汀，西酞普兰，催产素，N-乙酰半胱氨酸，丁螺环酮）与安慰剂之间无显着差异（P = 0.20）。同样，亚组荟萃分析也显示选择性5-羟色胺再摄取抑制剂（SSRIs）和安慰剂在治疗ASD的RRB方面无显着差异（P = 0.68）。没有证据表明出版物有偏见。这项荟萃分析对常规使用药物治疗自闭症谱系障碍的限制性/重复性行为几乎没有支持。需要使用精确的评估工具和长期随访对大型，平衡试验进行进一步的研究。该研究方案已在PROSPERO中注册（参考号：CRD42018092660）。