Autism Speaks and the Autism Clinical Trials Network report that a new low dose, melt-in-your-mouth version of Fluoxetine failed to reduce repetitive behaviors in children and adolescents diagnosed with Autism. Physicians’ clinical observations that Fluoxetine controlled these behaviors spurred this research. Fluoxetine is selective serotonin reuptake inhibitor (SSRI) that is commonly referred to as a “anti-depressant.” Researchers discovered that although Fluoxetine did reduce repetitive behaviors, the reductions were no greater than children given a sugar pill (placebo).
This story highlights the critical importance of subjecting clinical observations to well-designed, experimental investigation. My guess is that children with Autism perceive subtle parental verbal and non-verbal cues to reduce repetitive behaviors after intake of Fluoxetine and parents then (albeit unknowingly in some cases) provide positive reinforcement for these behaviors. Never underestimate the power of human expectation, or, stated differently, self-fulfilling prophecies. An interesting question: Is it ethical to give a child a sugar pill with suggestions that it will help reduce repetitive behaviors? You will have to decide for yourself as there are no easy answers to “Placebo Medicine.”
You can read the press release here.