The results of a new clinical trial were released yesterday, showing that Prozac, a commonly prescribed antidepressant, was no more effective than a placebo at treating obsessive-compulsive symptoms in kids with autism. Antidepressants, also known as SSRIs, are often used in the treatment of obsessive-compulsive behaviors in autistic kids and teens, but this study shows they should no longer be the go-to treatment solution.
SSRI stands for selective serotonin reuptake inhibitors. SSRIs like Prozac, Zoloft, and Lexapro are most often used to treat depression because they increase serotonin levels in the brain. Serotonin is the neurotransmitter responsible for feelings of well-being and happiness, as well as more complex processes of learning, memory and more.
But SSRIs have also been commonly used to treat obsessive-compulsive behaviors in children with autism. Autism spectrum disorders can involve a wide variety of symptoms, but these behaviors specifically can interfere with daily functioning. They can include hyperfocus and ritual “tics” like rocking and hand-waving.
As high as a third of all prescriptions to children with autism are for SSRIs. But “despite their widespread use, there is no evidence of the effectiveness of SSRIs for autism spectrum disorders in children,” pediatrician Dinah Reddihough at the Murdoch Children’s Research Institute told Science News.
Now, there’s even clearer evidence to back up Reddihough’s claim. In this new study, 109 kids with autism from ages seven to 18 completed a four-month trial to test the effectiveness of SSRIs on their obsessive-compulsive behaviors. They received either a starting dose of Prozac (brand name of fluoxetine) or a placebo.
Changes in their symptoms were measured by a long-standing behavioral survey used in other studies. After controlling for factors like age, sex, and symptom severity at the start of the trial, researchers found no difference in effect between Prozac and the placebo.
The researchers did note their sample size could have limited their ability to detect the drug’s benefit, but theirs isn’t the only study to reach this finding. A 2013 review of nine clinical trials involving 320 participants published in the Cochrane Library Systematic Review also found SSRIs provided no therapeutic benefit for children and adolescents with autism.
They, too, said that a larger study would make the results clearer — but with no medications currently proven to help with obsessive-compulsive behaviors in kids with autism, it’s a vital place to start.
“It’s really important that negative results are published,” pediatric neurologist Ann Neumeyer told Science News. This study shows “SSRIs are not the medication clinicians should go to first” for children with autism.