TRIMS Therapy Notes, Volume 5, Number 11, November 1984 Page: ATTACHMENT
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preliminary conclusions:
* Fenfluramine is effective in improving attention,
relatedness, and language in some autistic persons.
* For most children the gains are not sufficient-or
standard instruments are not sensitive enough to mea-
sure them-to result in significantly improved ratings
of intelligence and adaptive behavior.
* The best result is the reduction of the autistic
symptomatology itself. The drug seemed to improve
the participants' relatedness and communication,
reduce their bizarre behavior, and increase their atten-
tion to learning tasks. These were reflected by the
parents' records and the behavioral scores of the Ritvo-
Freeman scale.
* Fenfluramine, which is not yet approved for treat-
ment of autism by the Federal Drug Administration
and is one of the FDA's "orphan" drugs, is probably
safe for this purpose. Gains outweigh possible side
effects of slight weight loss and a few days' drowsiness
at first. Contraindicators may be a history of depression
and initial blood serotonin levels significantly below
normal.
We also have some observations that will not sur-
prise our colleagues.
* Gains on fenfluramine are much more significant
in children who are also in highly structured programs.
The medication heightens the effectiveness of a good
program; it does not replace it.
" During the placebo periods, hyperactivity and inat-
tentiveness returned in afew days, and the participants'
serotonin levels reverted to near baseline levels when
measured one month later. For the participants living
in unstructured settings, relatedness and behavior also
worsened during the placebo periods, but more gradu-
ally. In a structured setting, we believe, even without the
drug, autistic persons may be able to retain the
improvements they made during drug administration.With reduction of autistic symptoms, the children
may exhibit mental age-appropriate behavior that may
be misunderstood as misbehavior. Structure, counsel-
ing, training, and understanding are mandatory if the
autistic person is to achieve maximal gains from his or
her new awareness. For example, one participant's
heightened consciousness of his disabilities depressed
him and he dropped out of the study. We believe that
antidepressant medication for him and counseling for
the patient and family would have helped him under-
stand his new feelings.
Although preliminary data from some of the other
centers indicate that participants with the highest initial
intellectual scores gained most from fenfluramine, a
lower-functioning autistic child in our study expe-
rienced the greatest improvement. His IQ rose from 33
to 44 on the Merrill-Palmer scale.
We cannot make firm conclusions because our
sample was small, and neither the results of our
second-phase study nor those of the multicenter study
are yet available. We hope to repeat the study with a
larger sample, however, this time including a broader
group of people with pervasive developmental dis-
orders, particularly clients who suffer from self-injurious
behavior and who may have to enter institutions if no
other treatment is found.
TRIMS THERAPY NOTES
November 1984 Vol. 5, No. 11
clinical newsletter of the Texas Research Institute of Mental Scien-
ces, the research-training-patient care facility of the Texas Depart-
ment of Mental Health and Mental Retardation, an equal opportunity
employer.
Joseph C. Schoolar, Ph.D., M.D., scientific editor
Lore Feldman, editorFe1
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Lewis, Kay R.; Wood, David; Ho, Beng T.; Kreigel, Jeannine P. & Taylor, Dorothy. TRIMS Therapy Notes, Volume 5, Number 11, November 1984, periodical, November 1984; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1543220/m1/2/?q=%221984~%22: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.