What are selective serotonin reuptake inhibitors (SSRIs)?
Selective serotonin reuptake inhibitors (SSRIs) are antidepressant medicines traditionally used to treat depression, anxiety and obsessive compulsive disorder (OCD).
SSRIs include sertraline, fluoxetine, fluvoxamine and citalopram.
Who are SSRIs for?
SSRIs are sometimes prescribed for autistic people who show high levels of anxiety, depression, aggressive behaviour, repetitive behaviour or hyperactive behaviour.
What are SSRIs used for?
SSRIs are used to treat depression, anxiety, obsessive compulsive disorder (OCD) and some autism characteristics, like repetitive or aggressive behaviour.
Where do SSRIs come from?
The first SSRI, fluoxetine, was launched in 1987. SSRIs rapidly became the most widely used treatment for depression. They were also used to treat 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 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 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 characteristics similar to those of 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 medicine on a daily basis. The specific medicine and dosage depends on each person’s needs. Children are started on the lowest possible dose.
A GP, paediatrician or psychiatrist should monitor a child taking SSRIs. The child will need regular appointments with this doctor, especially during the first 4 weeks.
If a doctor prescribes SSRIs for your child, the doctor should also recommend a mental health therapy. This might be a therapy like counselling or psychotherapy, which can help your child understand and better manage their thoughts and feelings.
Does SSRI therapy help autistic children?
Research suggests SSRIs don’t change the core characteristics of autism in children. Also, emerging evidence suggests they might cause harm. For example, patients might have suicidal thoughts if they’re taking SSRIs for major depression.
It’s possible, however, that SSRIs might help some autistic children with anxiety, but more high-quality research is needed.
It’s also possible that SSRIs might help some autistic adults who also have depression or anxiety.
SSRIs can have side effects.
Who practises this method?
Your GP or paediatrician or a psychiatrist can prescribe selective serotonin reuptake inhibitors (SSRIs) and give you information about the potential benefits and risks of using them.
Where can you find a practitioner?
It’s best to speak to your GP, a paediatrician or a psychiatrist about this therapy.
You can find psychiatrists at Royal Australian and New Zealand College of Psychiatrists – Find a psychiatrist.
Parent education, training, support and involvement
If your child is prescribed selective serotonin reuptake inhibitors (SSRIs), you need to ensure your child takes the medicine. You also need to monitor the medicine’s effects, including any rare but serious side effects. If you feel that the medicine isn’t helping or is causing unwanted side effects, speak to your GP.
Cost considerations
The cost of this therapy varies depending on the brand of the selective serotonin reuptake inhibitor (SSRI) used and its dose or strength. It also depends on whether the medicine is covered by the Pharmaceutical Benefits Scheme (PBS) and whether you have a concession card – for example, a Health Care Card.
Therapies and supports for autistic children range from behavioural therapies and developmental approaches to medicines and alternative therapies. When you understand the main types of therapies and supports for autistic children, it’ll be easier to work out the approach that will best suit your child.