Antidepressants May Fail to Help Some Autistic Kids

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About a quarter of children with autism may be taking antidepressants that won’t help them, a new study suggests.

Antidepressants may fail to help some autistic kidsAutistic children are sometimes prescribed antidepressants to reduce repetitive behaviors, but the new findings suggest the drugs may not be as effective for this use as they seem.

Researchers at the University of Michigan analyzed results from both published and unpublished studies (unpublished studies have been completed, but have not appeared in a scientific journal). In all studies, children with autism were randomly assigned to receive serotonin receptor inhibitors (SRIs) or a placebo for at least four weeks.

When the researchers looked at results from the published studies alone, they saw a small but real benefit to the drugs. But when the results were adjusted to take into account the role of unpublished studies, the benefit of the drugs disappeared.

The researchers said the purported benefit of taking SRIs for kids with autism could be due to publication bias, a term used to refer to the selective publication of studies with positive results — or those that show a drug works.

“This research made it clear that the effects of SRI treatment in [autism spectrum disorder] are considerably overrated because of publication bias,” the researchers write in an article published today (April 23) in the journal Pediatrics.

Finding effective treatments for autistic children will be difficult if publication bias persists, the researchers said, because it will remain unclear whether drugs are actually effective.

It’s also unclear why five of the studies went unpublished. It could be that journals would rather publish studies with positive results, or that studies with negative results tend to take a longer time to get published. The Michigan researchers were able to obtain results from only one of the unpublished studies — the researchers who worked on the other four would not provide this information when it was requested.

It is not uncommon for studies involving children to go unpublished. Another study, also published today in Pediatrics, found that, of the 3,400 clinical trials involving children that have taken place since 2000 and have been registered with the government, about 70 percent have been completed, but less than one-third have been published.

When information from studies is not made available, “trials may be unnecessarily repeated, and the information cannot be used to guide therapy,” Dr. Scott Denne, of Indiana University School of Medicine, wrote in a comment about the new Pediatrics studies.

This problem could be solved by mandating that researchers post information from their trials to the same government website that is used to document trial registration (ClinicalTrials.gov), according to the researchers of the study on child clinical trials. Currently, registration of studies involving children and posting of results on the site is voluntary.

Source: http://www.foxnews.com/health/2012/04/23/antidepressants-may-fail-to-help-some-autistic-kids/#ixzz1sssp1NMq

Healthy Chill Pills

Can We Have Less Medication for Anxiety?

Medication & psychotherapy works, but can we do better?

By Mark Banschick, MD

Healthy Chill PillsAnxiety is fundamentally intrusive, interfering with going to sleep, preoccupying you while driving and preventing you from concentrating on what needs to be done. For many adults and their kids anxiety is always there, and if not, it’s always on the verge of being there.

It’s exhausting, and people want relief.

We live in a pill obsessed culture, so the reflex is to think medication.

Yet, other options are out there, and they often work.

Medications have a time and a place, but a little caution is not a bad thing. Other treatments range the gamut from diet changes, to meditation, to exercise to talk therapy. In addition, some treatments are based on better habits of living that will continue to help you years after the anxiety has abated. Sounds like a win win to me.

Healthy Chill Pills: Can We Have Less Medication for Anxiety?

According to the National Institute of Health, anxiety disorders are the most common mental illness among Americans, with some estimates reaching 40 million people. It’s generally accepted that effective treatment for most anxiety combines medication and psychotherapy. And, I agree. These protocals work and I’ve used them for years. The issue at hand is whether we can do better.

At Issue: So, are drug interventions always needed?

A common trap that people get into with medications in general, and especially psychiatric ones, is thinking that a pill will end their suffering. This may be the case if the ailment has one simple cause, for example, if an improperly treated wound becomes infected by bacteria, an antibiotic can often clear the situation up quickly with minimal side effects. However, anxiety and other psychological issues are more complex, and the effects of medication are less fully understood. And, with all the breakthroughs of modern science, the functioning of the most important organ in our body, the brain, is still oftentimes a mystery.

Example: The placebo effect of psychiatric medications is very high. This means that taking medications does help, but often the effect is less because of the pharmacological action of the agent, and more about your mind “believing” that the pill will work. The message here is that what makes drugs work, may be more complicated than you think. In fact it may be because of the way you think.

Most medications prescribed for anxiety disorders can be characterized as either antidepressants or benzodiazepines. Benzodiazepines can cause a relatively quick calm and are much appreciated by patients who are panicky. The antidepressants work more slowly but maintain a blood level every day so they have the advantage of muting some anxiety throughout the day. Side effects are varied. It is easy to get hooked on benzodiazapines because they work so quickly and can be quite effective. The antidepressants have a wide range of side effects, from rare cardiac issues, to weight gain or loss, to night sweats and more. Fortunately, most of the side effects of these meds are relatively benign, but who wants to be on medication if they don’t have to?

And here is the rub. In our society, the doctors, the patients, the managed care companies, and medical industry all push medications. It’s the easiest and, sometimes, the least costly of interventions. But does that make it good treatment?

Good research has shown that medication, especially combined with treatment from a competent therapist, can often give a person what they need to start down the road to recovery. But in the long run, the best way to manage symptoms of anxiety isn’t with a drug that might induce dependence or have other side effects.

Source: http://www.psychologytoday.com/blog/the-intelligent-divorce/201203/healthy-chill-pills

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