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Popular autism treatment found ineffective

Posted in News, Skepdude by Skepdude on June 1, 2009

READ THE REST OF THIS ARTICLE AT “MSNBC”

CHICAGO – An antidepressant that is among the most popular kinds of medicine used for treating autism didn’t work for most kids and caused nightmares and other side effects, new research found.

Results showed risks with Celexa outweighed any benefits in the largest published study of medication versus dummy pills for autism. That’s according to the lead author, Dr. Bryan King, director of child and adolescent psychiatry at Seattle Children’s Hospital and the University of Washington medical school.

The drug is not approved for treating autism. However, many doctors have prescribed it, thinking it might help prevent repetitive behaviors such as spinning, twirling and head-banging that are hallmark autism symptoms. Similar antidepressants have been shown to help treat repetitive actions in people with obsessive-compulsive disorder.

But in the autism study, Celexa worked no better than dummy pills. In fact, compared with kids on placebo, those on Celexa were more than twice as likely to develop repetitive behaviors, as well as other side effects including sleep problems and hyperactivity.

READ THE REST OF THIS ARTICLE AT “MSNBC”

Skepdude says – I did a quick search at PubMed and the author’s hospital to see if I could find at least an abstract of the study, but I was not lucky. As usual, I like to at least read an abstract just to get an idea of how the study was conducted and if there are any major issues with it which could affect the conclusions, since we know how Press Releases can be, but I couldn’t find anything. So the news itemsis all we have to go and it appears that this drug does not work any better than placebo. The real question though is why are doctors prescribing a drug which has not been tested for autism?

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6 Responses

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  1. red rabbit said, on June 7, 2009 at 10:45 PM

    Much of prescribing, particularly prescribing for children, is “off label.” Not all studies have been done. It is not always ethical to do such studies. We have safety data, and we have data about how a drug works in one group of people, so we can infer what might happen.

    Clonidine is a blood pressure drug with off-label uses in treating hot flashes of menopause, and symptoms of narcotic withdrawal. All birth control pills are used off-label to control acne.

    If we get some benefit, we continue the medication. Otherwise, we stop it. This decision taken with the cooperation of the parents or caretakers, or with the patients where consent is possible.

    This is a good study, above. It will be helpful in making treatment decisions.

  2. red rabbit said, on June 7, 2009 at 10:51 PM

    Having some problems with commenting. I don’t think this is a double post, but apologies if it turns out to be.

    Much of prescribing, particularly prescribing for children, is “off label.” Not all studies have been done. It is not always ethical to do such studies. We have safety data, and we have data about how a drug works in one group of people, so we can infer what might happen.

    Clonidine is a blood pressure drug with off-label uses in treating hot flashes of menopause, and symptoms of narcotic withdrawal. All birth control pills are used off-label to control acne.

    If we get some benefit, we continue the medication. Otherwise, we stop it. This decision taken with the cooperation of the parents or caretakers, or with the patients where consent is possible.

    This is a good study, above. It will be helpful in making treatment decisions.

    • Skepdude said, on June 8, 2009 at 9:55 AM

      Ok, but if we are doing these “off label” prescriptions, how do we know that they work? This sounds like it is based on anectodal evidence, and I generally speak against such practice. I have a problem with this as this plays right into the hands of the alt med folks. If you can do it with pharmaceutialcs, they’ll say, how can you criticize us? If a drug has not been shown to work, through the rigorous processes we expect them to go through, I have a problem with that drug being prescribed, especially to children.

  3. red rabbit said, on June 8, 2009 at 1:54 PM

    Off label uses are common because studies are done on fixed and defined populations. If a drug is shown to reduce cholseterol in men over 60 with an LDL >4, are you going to deny it to women?

    If a drug is shown to reduce anxiety in teenagers, and behaviour problems are associated with anxiety in kids with autism, is it not worth a try? Clearly, if there are significant risks to using this medication, it’s not going to be used.

    Off-label uses are based on a known mechanism of action in a proven “safe” drug (nothing is 100% safe, but safe within reason). They are part of post-marketing (stage 4) clinical trials.

    Viagra is a blood pressure drug which is lousy at lowering blood pressure. But it’s great at other things. Not just what you’re thinking: an off label use of viagra is lowering pulmonary arterial resistance in people with pulmonary hypertension. It prolongs lives off-label.

    Personally, I’m all for it.

  4. red rabbit said, on June 8, 2009 at 1:57 PM

    What’s happening? Real problems posting.

    Off label uses are common because studies are done on fixed and defined populations. If a drug is shown to reduce cholseterol in men over 60 with an LDL >4, are you going to deny it to women?

    If a drug is shown to reduce anxiety in teenagers, and behaviour problems are associated with anxiety in kids with autism, is it not worth a try? Clearly, if there are significant risks to using this medication, it’s not going to be used.

    Off-label uses are based on a known mechanism of action in a proven “safe” drug (nothing is 100% safe, but safe within reason). They are part of post-marketing (stage 4) clinical trials.

    Viagra is a blood pressure drug which is lousy at lowering blood pressure. But it’s great at other things. Not just what you’re thinking: an off label use of viagra is lowering pulmonary arterial resistance in people with pulmonary hypertension. It prolongs lives off-label.

    Personally, I’m all for it.

    • Skepdude said, on June 8, 2009 at 2:12 PM

      I don’t know, maybe it’s a WordPress issue.


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