OTRCTMolecular autism2020

Effects of bumetanide on neurodevelopmental impairments in patients with tuberous sclerosis complex: an open-label pilot study.

Dorinde M van Andel, Jan J Sprengers, Bob Oranje and 3 others

PMID 32381101

WHAT IT FOUND

Children with tuberous sclerosis complex taking bumetanide showed reduced irritability and improved social behavior.

However, this was a small open-label study with no placebo control, so the improvement may reflect expectation or natural variation rather than a proven drug effect.

Key findings

01The primary measure of irritability decreased significantly after treatment, with scores dropping from a mean of 14.2 to 8.3.

02Social responsiveness improved, with total scores on the Social Responsiveness Scale dropping from a mean of 81.9 to 65.3.

03Cognitive performance and seizure frequency did not change during the treatment period.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The study was open-label with no placebo group, so improvements in behavior could be due to expectation or the natural course of the condition rather than the drug itself. The sample size was very small, with only 13 participants completing the trial, which limits the reliability of the findings. Most participants were taking other medications for epilepsy or mental health at stable doses, making it difficult to isolate the specific effect of bumetanide. Patients with intellectual disability (IQ ≤ 70) were largely excluded from cognitive and brain wave assessments, so the results do not apply to that group.

Declared interests

The study was funded by Stichting TSC Fonds, a charitable foundation supporting tuberous sclerosis complex research. No commercial conflicts of interest were reported.

The easy way to misread this

Do not interpret the reduction in irritability scores as proof that bumetanide works. The study had no placebo control, and the improvements persisted after the drug was stopped, which suggests the changes may reflect natural variation or the effects of being in a structured study rather than a specific pharmacological benefit.

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