Citalopram No Better Than Placebo Treatment for Children with Autism Spectrum Disorders
A recent study has found that citalopram, a medication commonly prescribed to children with autism spectrum disorders (ASD), was no more effective than placebo treatment for these children.
Waring: According to researchers funded by the National Institute of Mental Health, a medication called citalopram works no better than a placebo at reducing repetitive behaviors in children with autism spectrum disorders—ASD for short. Dr. Bryan King is Professor and Vice Chair of the Department of Psychiatry of the University of Washington and director of Child and Adolescent Psychiatry at Seattle Children's Hospital. He is lead author on the study and explains its scope.
King: We proposed a study to look at whether the common usage of drugs like citalopram—in this case citalopram itself—was truly justified; whether citalopram would be effective in reducing repetitive behaviors that are so common in children with autism.
Waring: Dr. King adds that repetitive behaviors can have a profound impact on quality of life and are often the targets of ASD treatment. The behaviors include hand flapping, spinning, swaying and rocking. Since they are repeated over and over without any clear purpose, such behaviors can be disruptive, causing problems for the children or the people around them. Dr. King says the study findings do not support using citalopram to treat repetitive behaviors in children with ASD:
King: We certainly didn't find any evidence to support the effectiveness of this medicine for this particular indication. What we found was that citalopram and placebo did not distinguish themselves from one another; there was no separation. Waring: In a controlled study, a placebo, an inactive substance, is given to one group, while the drug being tested is given to a similar group; then the results obtained in the two groups are compared. Again, Dr. King:
King: The other finding of interest is that side effects were more common in the children who received citalopram than in the placebo.
Waring: Dr. King clarifies that while Citalopram did not work at treating repetitive behaviors in ASD, the drug is useful in treating such behaviors in obsessive compulsive disorder. He says Citalopram is in a class of medications that are among the most widely prescribed antidepressant drugs in the world, and also among the most widely prescribed medicines for people with autism. However, for Dr. King, the results raise questions about prescribing citalopram for children with ASD.
King: We need to rethink our use of this particular medicine for children with autism who are receiving it specifically in hopes that it will improve repetitive behaviors.
Waring: He adds that the results may challenge the idea that repetitive and inflexible behaviors in obsessive compulsive disorder are similar to repetitive behaviors in children with ASD. The study, conducted by researchers in the Studies to Advance Autism Research and Treatment network, was jointly funded by the National Institute of Mental Health and four other NIH institutes. The study was published in the June 2009 issue of Archives of General Psychiatry. This is Belle Waring, National Institutes of Health, Bethesda, Maryland.