From the Chicago Sun-Times
I think were several flaws in the steps leading to this drug being prescribed, in no particular order:Autism drug just caused nightmares: study
An antidepressant that's among the most popular kinds of medicine used for treating autism didn't work for most kids and caused nightmares and other side effects, researchers say.
The risks associated with taking Celexa outweighed any benefits in the largest published study of medication versus dummy pills for autism, said Dr. Bryan King, lead author of the study, reported Monday in the Archives of General Psychiatry.
The drug isn't approved for treating autism, but 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 placebos, those on Celexa were more than twice as likely to develop repetitive behaviors, as well as other side effects including sleep problems and hyperactivity.
Celexa is in a class of antidepressants known as selective serotonin reuptake inhibitors, which are widely used autism. The new research could "change this practice," said prominent Yale autism researcher Dr. Fred Volkmar.
- Parents desperate to "do something" for their autistic children. While I could see head-banging as damaging, twirling and spinning are much less likely to be harmful to to the child. While there are unhealthy extremes, I don't see repetitive behavior, in and of itself, to necessarily be so disturbing a symptom that it must be eradicated through medication. After all, many normal people find repetitive behaviors soothing when under stress (that's why we have rocking chairs, right?) and autistic people have quite a bit to be stressed about, such as communication difficulties.
- Parents desperate for the appearance of normality. Autistic people, particularly the young ones, can behave in weird ways. I don't blame the parents for wanting a magic pill to make the weird go away, but this one is not it. For now, it looks like we still have to laboriously and tediously educate autistic people in how to behave properly. Sort of like we have to do for all children, but more so in the case of autism.
- Doctors desperate to "do something" for their patients. Most doctors do care about people, that's why they go into medicine (well, that and money). It is extremely frustrating for them to be unable to help someone. There is a tendency for them to sometimes do something for the sake of doing something, nor is it limited to autism. I had to face that problem during my mother's final illness where at one point we had to tell medical people to just her alone already. Of course, the flip side is doctors giving up on patients, but that's a different topic.
- Assumption that a particular symptom always has the same cause. In this case: hey, obsessive-compulsive people engage in repetitive actions and this drug helps them, maybe it will help everyone with problem repetitive actions! It's an understandable thought, but such things need to be backed up be research. In this case, the research says nope, it won't help everyone. The symptoms may be similar, but the underlying causes are probably significantly different.
Clearly, this information needs to be disseminated so autistic children who are on this drug can be taken off it, since clearly it's not helpful. As I said, I understand the impulse to look for a magic pill to cure these people, but I don't think that will work any more than pharmaceuticals can cure a missing limb at this point. My opinion (subject to change with receipt of more information) is that what we currently have to help the autistic is educating them and training them to deal with the world as it is, a long tedious process that requires years. Note that I don't advocate hammering them into the appearance of normality but rather giving them tools with which to cope with the world and society. I also think we need to educate the families of people with autism to understand that there isn't a cure (at least not at this point) and they are going to have to cope with the fact that their relative is always going to be odd. We do not have a way to make these people normal (whatever that means anyhow) and there needs to be a certain level of acceptance for that or else we'll continue to see desperate parents pushing ineffective medication on their children.
What kind of moron would do that? Who are the morons who recommend that?
