Lamotrigine therapy for autistic disorder: a randomized, double-blind, placebo-controlled trial.
Lamotrigine is no better than a sugar pill for core autism traits.
01Research in Context
What this study did
Doctors gave kids with autism either lamotrigine or a sugar pill for 12 weeks. Nobody knew who got what.
They wanted to see if the drug would help core autism traits like talking, playing, or getting upset.
What they found
The drug group looked the same as the placebo group on every test.
Lamotrigine did not help language, play, or daily living skills.
How this fits with other research
Jepson et al. (2011) tried hyperbaric oxygen in kids with autism and also saw zero benefit. Two different pills, same null result.
Capio et al. (2013) tested risperidone in a similar RCT and found big drops in irritability. One autism drug works, one does not.
Laugeson et al. (2014) gave arbaclofen without a blind and parents saw gains. The open-label design may have hyped hope; the blinded lamotrigine trial shows why we need controls.
Why it matters
You can stop hunting for magic pills that fix autism. When parents ask about lamotrigine, show them this data and save them time, money, and side effects. Put your hours into ABA instead.
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02At a glance
03Original abstract
In autism, glutamate may be increased or its receptors up-regulated as part of an excitotoxic process that damages neural networks and subsequently contributes to behavioral and cognitive deficits seen in the disorder. This was a double-blind, placebo-controlled, parallel group study of lamotrigine, an agent that modulates glutamate release. Twenty-eight children (27 boys) ages 3 to 11 years (M = 5.8) with a primary diagnosis of autistic disorder received either placebo or lamotrigine twice daily. In children on lamotrigine, the drug was titrated upward over 8 weeks to reach a mean maintenance dose of 5.0 mg/kg per day. This dose was then maintained for 4 weeks. Following maintenance evaluations, the drug was tapered down over 2 weeks. The trial ended with a 4-week drug-free period. Outcome measures included improvements in severity and behavioral features of autistic disorder (stereotypies, lethargy, irritability, hyperactivity, emotional reciprocity, sharing pleasures) and improvements in language and communication, socialization, and daily living skills noted after 12 weeks (the end of a 4-week maintenance phase). We did not find any significant differences in improvements between lamotrigine or placebo groups on the Autism Behavior Checklist, the Aberrant Behavior Checklist, the Vineland Adaptive Behavior scales, the PL-ADOS, or the CARS. Parent rating scales showed marked improvements, presumably due to expectations of benefits.
Journal of autism and developmental disorders, 2001 · doi:10.1023/a:1010799115457