Which Meds?

by Kristina Chew

categories: Health, Science

Published June 25, 2009 @ 12:32AM PT

In a recently reported study, an SSRI (selective serotonin reuptake inhibitor), Celexa, was shown not to be effective in reducing repetitive behaviors. Another SSRI, Lexapro, is to be combined with research on genetics and brain scans in a five-year study (funded with a $9.6 million federal grant). The study seeks to "explore possible mechanisms behind this craving for routine." Geneticist Ed Cook, director of the Laboratory of Developmental Neuroscience in the psychiatry department of the University of Illinois-Chicago, notes that up to a quarter of individuals on the spectrum have "insistence on sameness." (My son certainly is in that number.)

From the June 24th Chicago Tribune:

Each participant in the study gets blood drawn for genetic tests, including an analysis of the genes related to serotonin, a neurotransmitter that is part of the brain's system for modulating mood and emotion. Participants' families are asked to donate blood samples so researchers can look for hereditary links. All the blood Cook collects from participants -- he's hoping for more than 250 -- will be shared with a national autism database for other researchers to use.

Participants with a high level of insistence on sameness are referred to the group's pharmacologist, Tom Owley. The outgoing head of UIC's Neurodevelopmental Psychopharmacology Clinic, Owley conducted a preliminary study two years ago on the antidepressant Lexapro, which affects serotonin levels. Sixty-five percent of participants who took the drug were helped, according to results of a detailed questionnaire completed by their parents.

The Celexa study is cited and the Chicago Tribune article specifically notes that study. By combining research on Lexapro with genetics and brain scans, it's hoped that researchers can find out why a drug may help some individuals but not others, with a view to developing "medications targeted for people with specific autism symptoms."

My son has been taking medications (SSRIs, though not Celexa or Lexapro; antipsychotics; others) since he was 7 years old. We've tried some other medications briefly; two of these---Ritalin and Clonidine---were very unhelpful and, indeed, had something more like deleterious results (as a result of which, Charlie took them only very briefly). My son having very limited speech---and being limited in his ability to identify and describe what he is feeling, physically as well as mentally---he cannot tell us how he feels taking a particular medication. Trying a new one, increasing a dosage, taking him off a medication: The only way we can gauge (guess) how he is feeling is by observing him very closely. And even then, it sometimes (most of the time) not always possible to tell what could be the medication, and what's Charlie reacting to things that have happened around him.

Charlie's responses to medications have often not been what what predicted. I still remember the time I gave him an over-the-counter medication---Benadryl---after he'd gotten his arms and legs covered with flea and fly bites at the beach. Maybe it stopped the itching, but, far from getting drowsy, he stayed up past midnight and was very lively (and of course, we had company that night). So finding out ways to determine whether or how an individuals with limited communication might respond to a medication before they take it would be very helpful. [Understatement] Not that it's that easy to have blood testing or brain scans done for my son---though, lately, he's done very good with various sorts of medical and other testing---you never know.