Monday, May 19, 2008

Professor Pushes Prozac for Autistic Children in the UK

Professor Eric Hollander, chairman of psychiatry at the Mount Sinai School of Medicine in New York, is recommending that more doctors in the UK consider prescribing drugs known as SSRI's, selective serotonin reuptake inhibitors, including fluoxetine, or Prozac, for autistic children as part of an overall treatment program.

The SSRIs are aimed at reducing anxiety and disruptive behaviors. The article Autistic children 'should be given Prozac to control their symptoms at appears to reference Dr. Hollander as stating that 37% of children in the US are currently taking SSRIs; many more than in the UK. Dr. Hollander claims that clinical trials with autistic children at low doses have shown improvements such as "fewer "endless ritual" behaviours, less anxiety and better social interaction" Recruitment of children for a "phase three" clinical trial is currently under way.

With respect to potential conflicts of interest the Checkbiotech article notes that in 2006, Neuropharm acquired the rights to develop fluoxetine for use in autism from the Mount SinaiSchool and that Professor Hollander is a consultant to the company.

I am not opposed to the use of medications in treating autism or symptoms of autism although we have never resorted to their use for Conor. I do believe that considerable care and caution must be exercised before their use. There is little discussion in the Checkbiotech article of possible negative effects of Prozac and other SSRI's on autistic children. The popular media and internet are full of articles alleging serious harmful side effects of Prozac. As a matter of intuition, and based on my son's own sensitivity to various environmental elements, I suspect that autistic children may be more vulnerable to any side effects that may be presented by Prozac and other SSRI use.

I also find it a little curious that a consultant for the company developing Prozac for use with autistic children is recommending greater use of Prozac for autistic children in the UK. This push is being made before completion of clinical trials. It is being pushed before assessment of the trial results by independent objective experts. How does Professor Hollander know that such products are effective and safe for autistic children before the studies are complete?


Anonymous said...

SSRIs are dangerous in ALL children. I took the entire battery of SSRIs as a kid, and I am autistic. I wound up suicidal by age 9 as a result, and nobody even cared. Seems there's nothing they don't think they can throw a pill at.

Anonymous said...

My son also tried SSRI's as a way to help him manage some anxieties and behaviours associated with his Asperger's diagnosis. No success. He also became suicidal, and sometimes would become so frantic he would run around the house, flailing his arms and shouting.

Quickly we discontinued use.

He still takes some medication, to help him sleep and calm racing thoughts, but SSRI's, although they were touted as being quite successful some years ago, have not been of any benefit in this case.

Medication, when necessary and if it helps improve the quality of life for the patient, but be very careful with those SSRI's. I think the drug companies have more influence in the marketing and use of drugs, than the actual science often supports.

Anonymous said...

My son has Asperger's and has been taking another SSRI (zoloft) for anxiety for two years now. He is eleven. We tried many things before we decided to do this. We had good supports in place at school, an excellent behavior plan and school and home, and a good social skills group. But as he grew older the anxiety just got worse.

We began slowly with a very small dose (25mg for a 65 pound kid). The improvement was dramatic, we never increased it. I had failed to understand how much of his behavior was driven by the anxiety. His disruptive episodes nearly disappeared. While he still loves fantasy, he no longer treats it as if it were real. Now he is happy more often than not and he is learning alot more in school.

I suspect that when we really understand autism we will discover that it is a dozen or more different disorders. What works for one child, won't work for others. But I would encourage another parent in a similar situation to at least consider SSRI's. With all medications I think it is very important to make formal observations about child's behavior before begining the medication and after starting it. Unless the improvement is perceptible, you don't want to bother with it or take the risk.

Anonymous said...

Our Pediatric neurologist has been suggesting Prozac for our Autistic son he he was 2. We did not do it because we thought he was too young and we wnted to try other alternatives first. My son is now 5 and we have tried all kinds of alternative medicine, diets, B12, etc, etc and frankly have not seen much improvement. We are reasy to try Prozac to attempt to control his PCD and anxiety. We still feel he is young but the doctor we are seeing has been treating patients from 5 and foloowed them to 20 years of age and has documented (not published) significant improvement in about 70% of of the cases. Some had to discontinue it due to adverse effects and some had no effects. So it is a hard decision but we will probably start next month and monitor closely.

mac4997 said...

The article is aimed at people trying Prozac on children who have AUTISM not Asperger's Syndrome. Asperger's Syndrome is on the Autism SPECTRUM, however, it is NOT true Autism. There is a HUGE difference between the two. With Asperger's Syndrome, people can generally function, communicate, talk, have insite of the world around them. With Autism, people CANNOT talk, or are VERY LIMITED in speaking. Do NOT know how to communicate, DO NOT understand the world around them, such as walking into a street could get them killed by a car, etc.. It angers me that people think Asperger's Syndrome is Autism and it's NOT. I have one of each and it's like comparing apples and oranges. It's a shame that Asperger's Syndrome is called Autism because that is a misleading statement and causes people to not realize how devastating and debilitating TRUE, CLASSIC AUTISM really is. Become aware...

tryintofixitmom said...

high five to you michelle. aspergers is totally not autism. people who have children with aspergers have no idea how having one with true autism is different. unfortunately, falling under the umbrella of "spectrum" allows these folks to the same supports and they are clearly not needed, also they create longer wait times for those who really need the help. as for prozac, i will be trying this shortly with my son who clearly has "autism" not a "dash of autism" and other than that, fully functional. he has already been on risperadone for 2 years with no improvement. and i think now the drug is having an adverse effect on him. hoping the antidepressant/antianxiety class of drugs work for his behaviors.