A new Cochrane Review looks at the issue of SSRI’s in use for autistic populations.
OBJECTIVES: To determine if treatment with an SSRI: 1. improves the core features of autism (social interaction, communication and behavioural problems); 2. improves other non-core aspects of behaviour or function such as self-injurious behaviour; 3. improves the quality of life of children and their carers; 4. has short and long term effects on outcome; 5. causes harms.
SSRIs (Selective serotonin reuptake inhibitors) do exactly what they say – they combat depression by ‘boosting’ serotonin. They are usually fairly effective in that role, although not all people with depressive tendencies use SSRIs, the majority tolerate them well. The most famous SSRI is Prozac.
The outcome of the study was:
There is no evidence of effect of SSRIs in children and emerging evidence of harm. There is limited evidence of the effectiveness of SSRIs in adults from small studies in which risk of bias is unclear
This is worrying. It indicates to me that autistic people are being treated for autism with SSRIs. Bearing in mind I haven’t read the full paper, it does read to me as though we are verging into the territory of chemical cosh.
A chemical cosh is shorthand for the administration of drugs to people who don;t actually require its benefit but who are kept quiet by its effects or side effects. This isn’t the fault of the drug or even the manufacturer but the prescriber. This is also not a situation unique to autism but is frequently found throughout all areas of mental health.
Left Brain Right Brain 
For what it is worth-my son was put on an SSRI at the age of six-not because of autism per say, but rather OCD. It changed his life-young as he was. Because of the general sentiment about medicating children-we struggled with the idea of giving him anything. As he got older and his language more pragmatic, we have been able to discuss this with him. There was a time when he asked to stop taking it and we complied..lowering his dose a little at a time. When he started having severe panic attacks, and getting caught up in repetitive thoughts, he asked to go back on it. The meds did not take away the OCD-i.e. the anxiety etc. They just lessened them. He is able to do the things he enjoys.
It is a scary decision when it comes to using meds with your children. I agree that they in many cases are the first thing offered. That is a sad state of affairs.
I would like to know if they studied the effectiveness of SSRIs in treating depression and anxiety in the Autistic adult population. It’s no surprise that the drugs don’t treat “autism” proper, but it makes sense that they would still treat what they are indented to treat even if the patient is Autistic. I believe there is anecdote to suggest that our population may be more sensitive to drugs, need lower doses, or perhaps experience side effects, but I haven’t seen any studies which actually address these hypotheses scientifically.
Kathleen – its true that some SSRIs are good for OCD and if an autistic child also has OCD then that requires attention too. I think this study was looking at instances where SSRIs were used as a de facto autism treatment.