A new analysis has been published which claims that there is no evidence for using antidepressants in autistic patients and selective serotonin reuptake inhibitors could actually harm children.
According to a team of Cochrane Library researchers in Australia, autistic spectrum disorders are difficult to treat because of the range of symptoms experienced by patients, including difficulties with social interactions and communication. SSRIs are among the most commonly prescribed medications, although none have been specifically approved for use in autism, using the rationale that they act on serotonin, the same chemical which is responsible for some of the psychological processes affected by the condition.
The researchers included a total of seven trials, involving 271 patients, in their study evaluating the SSRIs Prozac (fluoxetine), Luvox (fluvoxamine), Pondimin (fenfluramine) and Celexa (citalopram). They found no benefit in the five trials in children and some evidence of serious harm, including one child who suffered a prolonged seizure after taking citalopram.
The two trials in adults were very small and thus, “although there was some evidence for improvement in symptoms”, the authors concluded there was too little evidence for the drugs to be recommended. They noted that a major problem with analysing the results was that all the trials used different measures for assessing the drugs' effects.
Lead author Katrina Williams of the University of New South Wales & Sydney Children's Hospital said “we can't recommend SSRIs as treatments for children, or adults, with autism at this time”. She added that decisions about the use of SSRIs for “co-occurring obsessive-compulsive disorder, aggression, anxiety or depression in individuals with autism should be made on a case by case basis”.
Dr Williams concluded that “not all the SSRIs currently in use have undergone controlled trials for autistic spectrum disorders, but parents are often anxious to try treatments regardless of the lack of evidence”. She also said it is important that “doctors are open about the lack of evidence and explain any risks fully. before prescribing these treatments."