Facebook Dr. Anil Home page AutismItsGutStupid
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Clinicians frequently use drugs affecting brain function in order to manage the manifestations of autism. Here is further evidence how many of the medications prescribed for autism spectrum disorders (ASD) have little evidence to back their use. This post pertains to the use of tricyclic antidepressants (TCAs), a class of antidepressants with potential for significant side-effects.
Is It Leaky Gut or Leaky Gut Syndrome?
How do tricyclic antidepressants work in autism
Tricyclic antidepressants increase the neurotransmitters like norepinephrine and serotonin in the our brain. Use of TCAs for autism is based on their effects mediated via serotonin.
Tricyclic antidepressants for autism
While the use of tricyclic antidepressants in autism is common, how sure are we that they are actually effective, or it merely a placebo effect with side-effects? How do side-effects square with the strength of evidence for their efficacy in autism?
TCA-Autism Spectrum Disorders Study
Dr. Hurwitz and colleagues from the Department of Community Pediatrics, Liverpool Hospital, in Liverpool BC, NSW, Australia, conducted a meta-analysis and systemetic review of efficacy of TCAs in patients with autism.
The results of the study titled, "Tricyclic antidepressants for autism spectrum disorders (ASD) in children and adolescents. " were published in the Cochrane Database Syst Rev. March 2012.
FREE at Barnes & Noble: Doctor's Guide to Milk and Your Health: The Good, The Bad or The Slow Poison
Objectives of TCA Autism study
The investigators wished to examine if TCA treatment in autism improves:
- Social interaction and communication
- Stereotypic and repetitive behaviours
- Comorbid states, such as depression and anxiety
In addition, authors evaluated the potential for adverse effects of TCAs
Is It Leaky Gut or Leaky Gut Syndrome?
Methodology of TCA-Autism Study
The investigators searched the medical literature using a variety of databases for studies related to autism spectrum disorders including Cochrane Central Register of Controlled rials, MEDLINE, EMBASE, PsycINFO and CINAHL along with Dissertation Abstracts International via Dissertation Express, and the metaRegister of Controlled Trials.
- Only randomised controlled trials on use of tricyclic antidepressants as compared to placebo, in children and adolescents with autism spectrum disorders were included in data for analysis.
Results of TCA-Autism study
Despite the rigorous search outlined above, the investigators were able to find only three studies that met the inclusion criteria. Two of the studies used clomipramine and while one studied tianeptine.
- All the trials comprised of few subjects (12 and 32 subjects).
- Meta-analysis was not possible because of heterogeneity in studies
- Only one of the three studies found any evidence for possible short term effectiveness of tianeptine
- The results of observation of clinicians versus parents/teachers were contradictory. While parents/teachers reported benefit from tianeptine, the clinicians did not.
- Tianeptine use was associated with significant side-effects like drowsiness and reduced activity levels in these individuals while being treated with tianeptine.
- Similarly theresults of two studies on use of clomipramine were conflicting.
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Dr. Minocha's comments
- Be aware of the limited and conflicting evidence on efficacy of TCAs in autism.
- Be aware of that TCAs have potential for significant side-effects
- More studies are needed before tricyclic antidepressants can be prescribed with confidence for treatment of individuals with ASD.
Note: Results of studies pertaining to SSRI class of antidepressants are no more comforting. Williams et al in 2010 concluded that there is lack of evidence of efficacy of SSRIs in children. However, there is limited evidence favoring use of SSRIs in adults from small studies.
Is It Leaky Gut or Leaky Gut Syndrome?
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Dental sickness affects rest of body |
Exclusion diet in autism |
Complimentary and Alternative Medicine for major depression |
Probiotics de-stress gut dysfunction |
Fasting, health and longevity |
Yoga is not just exercise, has health benefits |
Acupuncture for digestive and other disorders |
Probiotics on market |
Melatonin is not just for sleep, helps gut |
Homeopathy: Fact or fiction |
Eating orders and spirituality |
Lifestyle measures to improve upper digestive health |
Is It Leaky Gut or Leaky Gut Syndrome?
Facebook Dr. Anil Home page AutismItsGutStupid
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Comments