July 16, 2001 -- There are few treatment options out there for children with autism, which places parents in a desperate situation. A new study holds out some small measure of hope, finding that the common household drug Pepcid, prescribed for heartburn, can reduce some behavioral problems seen in children with autism.
In the study, which appeared in the Journal of Neural Transmission, four of nine children treated with Pepcid experienced improvement in their autistic symptoms.
Although the most well-known example of autism may have been Dustin Hoffman's gentle Rain Man, author Linda Linday, MD, explains the disorder includes a range of severe behavior and psychiatric problems. Autistic children display minimal emotional attachment and poor social interaction, communication, language, and play. But they can also be hyperactive and aggressive and can make attempts to injure themselves.
Early and intensive behavioral and educational therapy is the primary treatment for these disorders, says Linday, while medications are used to treat select "target" symptoms.
She also emphasizes that Pepcid is not a treatment for autism itself but only useful in treating certain symptoms in some children. For instance, one child in the study displayed reduced irritability, and another demonstrated greater affection toward his mother. Another child who persistently repeated dialogue from a video did that less after treatment, she says.
Since the initiation of the study, Pepcid has become available as a generic prescription, famotidine, and in over-the-counter forms.
Linday is emphatic that parents wishing to try the medication should do so only under the supervision of a doctor and as part of an overall treatment plan.
"Although [Pepcid] is marketed over the counter, it is important for families to work with their child's prescribing physician to determine whether it is an appropriate treatment," she tells WebMD. "Medication treatment of a child with [autism] requires a medication treatment plan, and both general behavior and target symptoms need to be closely monitored. Children must also be monitored for possible adverse reactions."
The precise mechanism by which the drug may be working to improve behavior is unknown, says Linday, assistant attending pediatrician at St. Luke's-Roosevelt Medical Center and adjunct scientist at the New York State Institute for Basic Research in Developmental Disabilities. Previous studies have shown that children with autistic disorders have a higher incidence of stomach disorders, including heartburn -- which Pepcid is used to treat.
Many children with autism are unable to speak and are therefore unable to communicate that they are experiencing stomach problems, says child psychiatrist David Fassler, MD, who reviewed the report for WebMD.
"It is reasonable to suppose that kids in the study had undiagnosed stomach problems," he says. "The medication could have treated the stomach problems and might have made the kids less irritable and improved their behavior." Fassler is chair of the American Psychiatric Association's Council on Children, Adolescents, and Their Families.
Though none of the children in the study had been diagnosed or treated for heartburn, it is possible that they had an undiagnosed stomach problem that responded to the medication, agrees Linday.
Parents should not see this as a magic potion or a cure-all, cautions Fassler. "It's an interesting, small study which needs further evaluation and certainly a follow-up before we could appropriately recommend this treatment broadly."