Improving emotional face perception in autism with diuretic bumetanide: a proof-of-concept behavioral and functional brain imaging pilot study.
A ten-month course of bumetanide slightly improved emotion recognition and brain activity in autistic teens, but behavioral methods already do the same faster and cheaper.
01Research in Context
What this study did
Doctors gave the diuretic bumetanide to a small group of teens and young adults with autism. They wanted to see if the drug would help them read emotions in faces.
Before and after ten months of daily pills, the team tested emotion recognition and took brain scans while the youth looked at emotional faces.
What they found
Parents and clinicians saw small gains in how well the youth named feelings from photos. Brain scans also showed brighter activity in areas that handle faces and emotions.
The drug was safe enough for an open pilot, but the study had no control group.
How this fits with other research
Tiede et al. (2019) and Han et al. (2025) show that naturalistic ABA programs already boost social skills in preschoolers. Bumetanide adds a pill option for older youth who still struggle with faces.
Laugeson et al. (2014) tested arbaclofen, another autism drug, and also saw social gains in an open-label design. Both pills need placebo trials before real-world use.
Gordon et al. (2014) got similar face-reading gains with a 15-minute computer game. The drug route is slower but may help youth who do not respond to brief training.
Why it matters
If you work with teens who still misread faces after years of behavioral teaching, bumetanide could one day join your toolkit. For now, track the upcoming RCTs and keep using proven ABA or VR programs while the science catches up.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Continue your current social-skills program; note any teen with persistent face-reading deficits for future physician referral if RCTs support the drug.
02At a glance
03Original abstract
Clinical observations have shown that GABA-acting benzodiazepines exert paradoxical excitatory effects in autism, suggesting elevated intracellular chloride (Cl-)i and excitatory action of GABA. In a previous double-blind randomized study, we have shown that the diuretic NKCC1 chloride importer antagonist bumetanide, that decreases (Cl-)i and reinforces GABAergic inhibition, reduces the severity of autism symptoms. Here, we report results from an open-label trial pilot study in which we used functional magnetic resonance imaging and neuropsychological testing to determine the effects of 10 months bumetanide treatment in adolescents and young adults with autism. We show that bumetanide treatment improves emotion recognition and enhances the activation of brain regions involved in social and emotional perception during the perception of emotional faces. The improvement of emotion processing by bumetanide reinforces the usefulness of bumetanide as a promising treatment to improve social interactions in autism.
Autism : the international journal of research and practice, 2015 · doi:10.1177/1362361313514141