The good, the bad and the ugly about medication use in ASD

This week’s podcast summarizes recent evidence on why there is good and bad in treating autism with medication, but there is also lots of ugly.  While new medications are being developed and researchers are looking into new ways of measuring change across time time, medications are not effective in treating the core symptoms of autism and they have pretty harsh side effects which, you guessed it, are dealt with by prescribing more medications.  There are a lot of reasons to be hopeful about the future of medication use in autism, but lots of reasons to feel frustrated too.

 

Here are some of the articles that were cited:

https://www.ncbi.nlm.nih.gov/pubmed/23101743

https://www.ncbi.nlm.nih.gov/pubmed/25885012

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520775/

 

Oops the media did it again…

Last week CNN.com reported on a study that showed slight improvement of autism symptoms in children that received a single infusion of their own umbilical cord blood.  While the study was interesting, the authors were the first to acknowledge the limitations, however, this did not stop the media from misrepresenting the results.  Details are explained in this podcast.  In addition, a big win this week for precision or personalized medicine:  different symptoms and different genetic mutations are linked to different outcomes from different anti-seizure medications.

A message for MLK’s birthday and a better way diagnose anxiety

Happy MLK day – a day when we recognize a man for his contribution in justice, tolerance, equality and service, I highlight a supreme court case which affects how those with special needs are fighting for justice and equality.   Also, over the holidays, Dr. Connor Kerns from Drexel University published how a new tool to diagnose anxiety in those with autism was validated, setting the stage for its use by physicians and clinicians who don’t have a lot of experience with autism to help better understand the symptoms of their patients.

Why is there a link between c-sections and autism?

Happy New Year!  Over the holiday break, a the largest study so far including the most number of countries analyzed the risk of having a c-section and autism.  They found a consistent increase risk that wasn’t due to cause of the c-section or the age of the infant (preemie or term).  So what is going on?  This week’s podcast warns against the unintended consequences of linking c-sections to autism and offers an explanation of the findings in addition to what the study authors provide.

Managing real life autism situations.

Compared to researchers, community clinicians don’t have time for the same rigorous training on the standard autism diagnostic instrument called the ADOS, so can they still do it as well?  Or does this group not have the resources they need to use it properly?  Also, because psychiatric hospitals don’t see as many people with autism as they used to, a group of child psychiatrists got together and wrote guidelines for what to do if a child with autism showed up at the general inpatient ward.  These are things that face families in the real word, and we thought you should hear about new science around them.

Is ADHD part of the spectrum diagnosis of ASD?

A recent study examining some people who lost an autism diagnosis (and were possibly reclassified) reinvigorates the idea that attention deficit hyperactivity disorder may be on the autism spectrum.  It shouldn’t be part of a valid ASD diagnosis, but there may be some symptoms of ASD that overlap with ADHD.  Also, a new editorial emphasizes that while new discoveries are important and exciting, what happens to make them useful for people outside a research study takes a lot of work, time and money.

Treatments for social reward in autism: inject it, snort it, or possibly smoke it.

This week saw two new studies on the “love hormone” called oxytocin.  In the first, the IV drip for oxytocin is replaced by a nasal spray.  The results are mild and focused on one type of symptom, but exciting and promising nonetheless.  The second study investigated how oxytocin works in the brain and shows how it interacts with a chemical called anandamide in a region activated by sex, drugs and food.  This may explain why people find social reward pleasurable.  It lays the groundwork for other compounds which may enhance social reward, but more studies are needed.   Finally, a short recap last week’s podcast where High Risk Baby Siblings researchers are finding that the range of possible issues that kids at risk have isn’t focused just on autism symptoms.

A traditional strategy in autism intervention may be hurting not helping.

Two interesting studies this week.  The first from researchers studying a learning strategy called repetition.  As it turns out, it may impair the ability for people with autism to generalize what they learn into new situations, like learning that a golden retriever is a dog and a beagle is also a dog.  Also, researchers in Australia comb the autism literature to determine what the financial costs and benefits of supportive employment are and discover that getting people with autism employed is good for the soul and good for the economy.  That study is open access and can be found here:  http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0139896