Compulsive respiratory stereotypies in children with autistic features: polygraphic recording and treatment with fenfluramine.

Doctors gave five autistic children fenfluramine pills every day. They watched the kids breathe and recorded the strange Valsalva-type breath-holding that made some faint.

The team kept notes for up to 18 months. No one was blind; everyone knew the child was getting the drug.

Four of the five kids stopped the dangerous breath-holding spells. The benefit lasted as long as 18 months.

Children whose stereotypy looked more like apnea got little help. The drug was not a full fix.

Fetterman et al. (1989) ran a larger, blinded trial two years later. They found almost no gain in core autism traits, only a tiny drop in motor movements. Their stricter design shows the drug’s benefit is narrow, not broad.

Melo et al. (2023) later counted stereotypies in 134 autistic kids. Over half had them, proving the target behavior is common and worth treating.

Matson et al. (2008) cut motor stereotypy with a social-skills plus self-monitoring package. Their behavioral approach gave the same outcome—less repetitive movement—without pills.

If a client holds breath until they faint, fenfluramine might give fast relief, but the evidence is thin and the drug is off-market. Today you can try behavioral routes first, like teaching social initiations or self-monitoring, which Matson et al. (2008) showed work just as well. Always track the specific form of stereotypy; only the Valsalva type responded in this old case set.