The Final Word on Antidepressants and Autism Risk???

Every time you turn around there is another study contradicting the last on antidepressant use and autism risk.  An answer on why there are differences across different studies may be found in a new analysis published by University of Washington and SSM Dean Medical Group in Wisconsin this week.  They showed that autism severity (not risk) is increased only with both a likely gene disruption AND following antidepressant exposure in pregnancy together.  This suggests a double hit model similar to other complex neuropsychiatric disorders like depression.  It also suggests that findings from other chemicals, like PBDE’s, may be dependent on gene / environment interactions too.  After all, a new systematic review showed PBDE’s during pregnancy are bad for the IQ of the child.  This provides insight on ASD risk and subtype given the multitude of possible genetic / environmental combinations out there.

A different type of autism?

Last week, investigators with the Autism Treatment Network published a long awaited study on the differences between the DSM IV and DSM5.    Other studies had relied on information on old pieces of paper to judge whether or not someone who met criteria under DSM IV would be now diagnosed with DSM5 criteria.  This study, on the other hand, used in person evaluations of over 400 individuals with autism.  PI from the Missouri site and lead author of a new study, Dr. Micah Mazurek was gracious enough to provide a summary of the findings in the podcast.  A quick preview:  they showed differences in the diagnosis in the group previously known as PDD-NOS.  Is this a new type of autism?  Their symptoms were less severe and they had normal IQ ability – do they have a subtype of autism or a new form of ADHD?  This study isn’t the first to suggest using different categories of symptoms of autism like DSM IV did, and indicates that the new criteria of the DSM  5 are more specific.  In addition, a 2 minute summary of all the great presentations at the Autism Society of America is given.  Totally insufficient to describe everything that went on, but it’s a start.

Making sense of toxic chemicals and risk of autism

On Monday the 1st, a consensus statement from over 50 expert scientists was published that collectively emphasized the link between toxic chemicals and neurodevelopment disorders like autism, learning disabilities and ADHD.  In this podcast, we want to help you understand why this is relevant for autism.  If you want to learn more about this statement and read about specific actions that can be taken to minimize exposures to these chemicals, go to www.projecttendr.com.  We will also be having a live chat about it on July 11th at 2PM EST.

Autism across the ages

Two studies from Sweden came out this week with the same idea: study autism across time, and focus on other things besides just autism. This podcast reviews both. The first examined quality of life in adults over the course of 20 years and the other followed preschoolers into school age. The results are consistent. That is, people with autism have high levels of psychiatric comorbidities which depended on a number of factors. Of particular importance is the role of intellectual functioning on outcome. These recent data are further evidence that while people with autism share struggles, those with ID may need to be considered differently in clinical care, housing, employment, and obviously intervention.

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.

What if it isn’t autism?

Many times signs and symptoms of autism may be seen prior to 3 years of age, but a diagnosis is not made.  It may not be autism, but what is it?  Studying children at risk for developing ASD but then don’t go on to receive a diagnosis gives researchers a clue.  Dr. Meghan Miller from the University of California at Davis discusses a study that follows up these kids to 9 years of age and finds out what is going on with them.  Do they have autism after all?  Or do they have absolutely no symptoms at all?  Or is there something in between?