Charles Nelson Reilly tells the story of how his Aunt Lily lost her hair.
I think I probably come off sometimes as opposed to science, and nothing could be further from the truth. What I'm opposed to is pretending that something is science when it's really just a theory. I'm against widespread use of treatments before they are thoroughly tested. I think it's very dangerous when we pretend something to be good science just because we want so badly for it to be.
If you don't understand why, please watch the clip above from Charles Nelson Reilly's autobiographical stage show. Yeah, the guy from Lidsville. What happened to his Aunt Lily because a doctor was excited about a promising new treatment breaks my heart.
Which brings me to SSRIs. Not for kids, helpful in small doses for many adults with autism, and apparently not a good idea for pregnant women. Does anyone doubt antidepressants have been overprescribed before anyone could understand their long term consequences?
A new study indicates that taking SSRIs during pregnancy may increase the risk of a woman giving birth to a child with autism. And, yes, they did try to make sure that what they were measuring was not the likelihood of someone with depression to have an autistic child:
The authors also looked at which mothers had a history of depression or another mental-health problem: that included about 12% of mothers whose children had an autism spectrum disorder, and 9% of mothers whose children did not. But when researchers adjusted for mental-health history, the association between SSRI use and autism persisted.
"Almost everybody getting an antidepressant has some mental health disorder, and our study adds to the body of knowledge that shows that a family history of mental health problems may be associated with autism," says Croen. "But our study indicates that it isn't necessarily the mental health disorder, it was the treatment. When we controlled for the treatment, we didn't see any association or any increased risk of autism associated with maternal depression or anxiety."
A few days ago, I explained that, although Simon Baron-Cohen has access to excellent data, he often uses it to merely make stuff up and pretend it's science. And that some of the stuff he makes up is harmful:
Where Baron-Cohen's work gets dangerous is his belief that autism is caused by an excess of testosterone. I really think this comes from his initial linking of autistic people with the hyper-aggressive Nazis, and not from anywhere else. And it's a profoundly dumb and dangerous idea.
The Baltimore Sun inexplicably gives Mark Geier the opportunity to plead his case today, and he makes clear exactly how dangerous this theory of high testosterone is:
Over the years, our work has helped to uncover that a significant number of children with autism have remarkably high levels of male hormones in their blood. We have found that many of these children with high male hormone levels display behaviors that are among the most challenging to deal with in autism, such as unprovoked and extreme violence, to themselves and the people around them, and an inability to sit still for beyond a few seconds. These behaviors make it all-but-impossible to engage children in the more well-known forms of behavioral therapy.
So Mark Geier decided it would be a good idea to treat autistic kids with the chemical castration drug Lupron. I've already written about the role that chemical castration played in the suicide of Alan Turing-- it's unimaginable to me that anyone would find it an appropriate treatment for autistic people. But Geier not only used it-- he got insurance companies to pay for it:
Some critics have charged that there's little oversight for our use of this therapy, and that we are profiteering off of desperate parents. But they neglect to mention that physicians employed by insurance companies are signing off on what we're doing.
Pharmaceutical companies charge thousands of dollars per month for Lupron treatment — money that, for virtually all of our patients, is covered through medical insurance. Not surprisingly, the insurance companies demand that their own doctors review extensive blood tests and other analyses before signing off on reimbursements for Lupron. And the insurance companies require regular updates to those blood tests to assess whether continued injections are medically justified.
Geier's hilarious argument: it must be ethical-- insurance companies have signed off on it!
You may wonder why I blame Baron-Cohen if Geier's own research found high levels of testosterone in kids with autism. You find what you look for. Most kids don't have their levels of testosterone tested, ever, and they can fluctuate wildly. This makes it impossible to know how unusual the results used by Geier to justify treating kids with autism actually are.
Would he actually have gotten doctors and insurance companies to sign off on it without Baron-Cohen's work? I don't know. I know that Simon Baron-Cohen should feel partially responsible that kids with autism have been treated by chemical castration. His theory-- autism is caused by high testosterone-- makes it seem like a good idea. His authority gave Geier's dangerous snake oil credibility.