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Literature suggests that there is strikingly lack of good data to support the use of pharmacological agents in general for autism. Recent data also suggests that tricyclic antidepressants are not of much help in autism. No wonder, some studies indicate that use of micronutrients is superior to pharmacological treatment.
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Antidepressant medications particularly selective serotonin receptor inhibitors (SSRIs) are commonly used for treatment of behavioral problems including and not limited to the treatment of repetitive behaviors in autism spectrum disorders (ASD).
Dr. Carrasco and colleagues from the Neuroscience Graduate Program, University of Michigan, Ann Arbor, Michigan examined the literature supporting the use of such drugs and their reliability based on publication bias. They published their results in a report titled, “Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication Bias” in the journal Pediatrics 2012.
Methods of Autism Antidepressant SSRI Medications Study:
The investigators searched the scientific literature including Pubmed/Medline for the gold standard randomized, double-blind, placebo-controlled trials examining the role of SSRIs for repetitive behaviors in autism.
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Outcome measures studied included:
- Rating scales of repetitive behavior
- Publication bias using funnel plot, and a meta-regression of sample size and effect size
Results of Autism Antidepressant SSRI Medications Study:
- 5 published and 5 unpublished but completed trials were available for analysis
- Meta-analysis of 5 published and 1 unpublished trial for which data was available showed a small but significant effect of SSRI for the treatment of repetitive behaviors in autism spectrum disorders
- Publication bias was seen in the studies included in analysis
- Importantly, statistical adjustment/correction of data for publication bias showed that the effect of SSRIs was not statistically different from placebo
- There was no significant effect of off type of drug or treatment duration on SSRI efficacy
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Conclusions of Autism Antidepressant SSRI Medications Study:
- The available scientific data demonstrating slight benefit of SSRIs for treatment of repetitive behaviors in autism spectrum disorders is actually likely to selective publication of trial results and has been especially noted with use of antidepressants.
- The investigators commented that “Without a timely, transparent, and complete disclosure of trial results, it remains difficult to determine the efficacy of available medications.”
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