Tuesday, October 06, 2009

Antidepressants no help for autistic kids

An antidepressant commonly prescribed to help autistic children control their repetitive behaviors is actually no better than a placebo.

Roughly a third of all children diagnosed with autism in the U.S. now take citalopram (Celexa), the antidepressant examined in the study. The results of the nationwide trial, published in Archives of General Psychiatry.

Because very few medications have been tested on autistic children in large, rigorous studies, doctors have looked to drugs that treat similar symptoms in other conditions, such as obsessive-compulsive disorder or attention-deficit hyperactivity disorder. That's what led physicians to a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs, that help adults with obsessive-compulsive disorder.

Dr. Bryan King, director of psychiatry and behavioral medicine at Seattle Children's Hospital and leader of the study, said he was shocked to find that citalopram didn't help patients. Not only was the placebo slightly more effective, but the drug's side effects -- such as impulsivity and insomnia -- were at least twice as bad, the study found.

"I personally would have a healthy dose of skepticism about" prescribing citalopram or other SSRIs, King said.

The study underscores the value of evaluating drugs in randomized, double-blind, placebo-controlled studies, which are considered the gold standard of medical research, Dr. Fred R. Volkmar, director of the Yale Child Study Center in New Haven, Conn., wrote in a commentary that accompanied the study.

Bonnie - this is an ideal example of why doctors should not be allowed to use drugs off-label without rigorous trials.

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