What are selective serotonin reuptake inhibitors (SSRIs)?
Selective serotonin reuptake inhibitors (SSRIs) are antidepressant medications traditionally used to treat depression, anxiety and obsessive compulsive disorder (OCD). SSRIs include fluoxetine (Prozac) and citalopram.
Who are SSRIs for?
SSRIs are sometimes prescribed for autistic people who show high levels of anxiety, depression, repetitive behaviour, aggressive behaviour or hyperactive behaviour.
What are SSRIs used for?
SSRIs are used to treat depression, anxiety, obsessive compulsive disorder (OCD) and some characteristics of autism, like repetitive behaviour or aggressive behaviour.
Where do SSRIs come from?
The first SSRI, fluoxetine (Prozac), was launched in 1987. SSRIs rapidly became the most widely used treatment for depression. They were also found to be helpful in treating OCD and anxiety.
Since the 1980s, researchers have tested SSRIs for use with autistic people who also have anxiety and OCD.
What is the idea behind using SSRI therapy for autistic people?
Serotonin is a neurotransmitter – that is, a chemical messenger that carries messages to and from the brain. It regulates sleep, mood and emotions. Lack of serotonin has been linked to a range of conditions including anxiety and OCD.
SSRIs can be used to help regulate serotonin. Changing the balance of serotonin seems to help brain cells send and receive chemical messages.
SSRIs are an effective treatment for anxiety, which is common among autistic people.
Also, autistic people have some similar characteristics to people with OCD, including repetitive behaviour, special interests and a preference for routines. SSRIs are effective for treating OCD, so researchers believe that they might also improve similar characteristics in autistic people.
What does SSRI therapy involve?
This therapy involves taking oral medication on a daily basis. The specific medication and dosage depends on each person’s symptoms. Children are started on the lowest possible dose.
A medical practitioner, like a GP, paediatrician or psychiatrist, should monitor a child taking SSRIs. The child will need regular appointments with this practitioner, especially during the first four weeks.
Cost considerations
The cost of this therapy varies depending on the brand of the selective serotonin reuptake inhibitor (SSRI) and its dose or strength. It also depends on whether the medication is covered by the Pharmaceutical Benefits Scheme (PBS) and whether you have a concession card – for example, a Health Care Card.
Does SSRI therapy work for autistic people?
Research suggests SSRIs aren’t effective for children, and emerging evidence suggests they can cause harm. But it’s possible that SSRIs might help some autistic adults who also have depression or anxiety.
SSRIs don’t appear to help with the core characteristics of autism.
More high-quality studies are needed.
Who practises this method?
Your GP, paediatrician or child psychiatrist can prescribe serotonin reuptake inhibitors (SSRIs) and give you information about the potential benefits and risks of using them.
Parent education, training, support and involvement
If your child is taking selective serotonin reuptake inhibitors (SSRIs), you need to ensure your child takes the medication. You also need to monitor the effects, including any rare but serious side effects.
Where can you find a practitioner?
It’s best to speak to your GP, a paediatrician or a child psychiatrist about this therapy.
You can find a child psychiatrist by going to Royal Australian and New Zealand College of Psychiatrists – Find a psychiatrist.
There are many therapies and supports for autistic children. These range from behaviour therapies and developmental approaches to medications and alternative therapies. When you understand the main categories that these therapies and supports fall into, it’ll be easier to work out the approach that will best suit your child.