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Sunday, 6 October 2013

Autism - Drugs and Supplements that actually do work

Following requests for more information about supplements and drugs that really do seem to help with autistic behaviours, I have updated my "Top Tips" page.  Here is the updated information for anyone who is interested.

You will find links to the science behind all these ideas in various posts on my blog.  Many of these are "off label" applications, since there are no treatments yet  licensed for autism.

From comments received, it is clear people want "supplements" because they are available without prescription.  The rules vary widely from country to country.  A supplement in the US may be a drug in the UK and vica versa.  Or even a drug in UK is a supplement in Germany.  Just do some research on the internet.
 
Since I am not a doctor, this is not medical advice.  Since your doctor does not read the autism research, he/she will probably not be able to help you.



Anti-oxidants

Science established some time ago that oxidative stress plays a central role in autism.

There is one widely available antioxidant that is highly effective. It is called NAC  (N-Acetyl Cysteine) and is available without prescription via the internet (from Amazon for example) or many pharmacies.

The result is very dose dependent.  Some people take time to adjust to it, due to mild stomach irritation.  Most supplements come in 600mg capsules.  Two capsules has an effect, but the effect becomes larger as you increase to about 3g per day (i.e. 5 capsules per day).  You should observe a great reduction in obsessive behaviours within a few days.  Then new good behaviours should emerge quite rapidly.  Speech increases.

To read about this on the blog, go to the list of labels and click on GSH.


Neuroprotection and anti-inflammatory

The research is conclusive that there is chronic neuroinflammation in autism.  The anti-oxidant will contribute to managing this, but an anti-inflammatory agent that can reach the brain will give additional benefit.

This blog has highlighted research to show that widely used drugs called Statins have a secondary effect that reduces neuroinflammation.

The Statin I choose is Atorvastatin, but Simvastatin also looks a good choice.  In the UK Simvastatin is available without prescription.

I use 10mg Atorvastatin.  The behavioural improvement was visible within two days.  New behaviours involving initiative emerge.

To read about this just click on statins in the list of labels.


GABA Neurotransmitter

Research going on for 10 years in France has shown that the widely used diuretic Bumetanide reduces the level of chloride in the brain.  The high level of chloride causes the brain neurotransmitter GABA to malfunction in autism and babies with neonatal seizures.

The effect of taking 1mg of Bumetanide has a dramatic behavioural effect.  It improves the child's ability to control himself.  He appears more "present" and not in his own world, this results in more interaction with his peers and an improvement in mood and a general increase in happiness.  Speech increases.

To read about this just click on bumetanide in the list of labels.


Autsim flare-ups  -  over activated mast cell response to allergens

Violent episodes may sometimes be provoked by an allergic reaction caused by so-called, mast cells.  What in a typical child might just cause a runny nose or sneezing, may cause violent/aggressive behaviour in a child with ASD.

A cheap over the counter drug drug called Claritin, acts as an anti-histamine H1 antagonist, it will subdue the allergic reaction within a few tens of minutes.

Many people do not respond to a particular anti-histamine, if one does not work just try a different one.  Your pharmacist can suggest an alternative (levoceterizine for example).  The brand names vary by country.

If the child complains about creepy feelings on his/her legs this would be an indicator or this type of allergic reaction.

There are other serious behavioural causes of self injury, but if the child is normally well behaved and under self control, sudden outbursts may be being triggered by mast cells.  Read all about mast cell research here.


Lower Serotonin Levels 


High serotonin levels are a known biomarker of autism;  lowering them does indeed appear to reduce autistic behaviours.   
You can do this via diet.  Avoid food known to raise serotonin, for example bananas and caffeine.  A low carbohydrate, high protein diet is known to lower serotonin levels.  The Atkins (induction phase) diet and the Ketogenic diet are also known to lower serotonin levels.  You will know if it is working because lowering serotonin increases appetite, your child should put on weight.
The easier way is with a serotonin antagonist like Periactin, often prescribed in the US to underweight children.  Periactin is a first generation antihistamine drug, so it will cause drowsiness.  It is known to be antiserotonergeric.  It is available OTC in some countries.

Read the post on Serotonin here.


Increase acetylcholine levels
The story about acetylcholine is quite complex, and the full post about it is here.
To increase acetylcholine there are various options.  The drug options shown to be effective work by affecting the enzyme acetylcholinesterase.  The two drugs shown to be effective in autism are Galantamine and Donepzil.  These are prescription drugs.
The same effect is possible using a nicotine patch, or even potentially by using nicotine gum.  One quarter of a 7mg patch applied for 6-8 hours is suggested by one US doctor.
The other method, that is sometimes combined with Donepzil, is to give the dietary supplement choline, which is widely available.
 

High potassium diet reduces sensory overload

If your child with ASD, like most, has a problem with sensory issues like sound, light, smell etc, there is a dietary solution.  Increase potassium in his/her diet - eat more bananas, oranges, kiwis, potatoes etc.  You can also use potassium + magnesium supplements.  If you live in the US, beware of these supplements, they are very weak.  A banana has 500mg of potassium,  US supplements contains up to 100mg, UK supplements are up to 200mg.  Magnesium plays a role as well, it is needed to maintain potassium levels.  I use a cheap French supplement with 500mg Potassium and 150 mg Magnesium, taken half AM and half PM.  Potassium supplements can irritate the stomach, but they do modify autistic behaviours for the better.
Potassium ion channels (like Kir 4.1) play a role in the brain in both ASD and epilepsy.  It is very complicated and still not fully understood, but it WORKS! 
 
 

8 comments:

  1. Hi,
    I find what you're discovering very interesting. My son is on the spectrum and is now a young adult. His sister has Juvenile Myoclonic Epilepsy that is under control with diet (modified atkins) and lifestyle modifications (touch wood, she's now at uni, so i'm hoping she's able to stick to it).
    They both have atopic issues, bad hay fever, one asthma which remitted at puberty, the other eczema with asthma appearing now. We always found that ASD/epilepsy symptoms improved during allergy and fever (not pre- symptoms but definitely when redness/itchiness/runniness/sneezing appear. In fact anti-histamines twice triggered catatonic episodes in my son).
    I think there is an interaction between GABA and histamine that needs to be looked into...it's possible that this is a paradoxical reaction along the lines of the Bumetanide research and that histamine performs a 2nd line inhibitory function for some? Lowering histamine certainly doesn't help in epilepsy.
    Also, in that state my son had alcohol cravings, v weird in someone who normally has no interest in drink at all!
    Anyway, I find your blog really interesting, respect to you for getting this information out there. Perhaps, who knows, one day we'll work it out!
    regards,
    janet

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    1. Dear Janet
      Glad you like the blog, once you start putting all the pieces of the puzzle together it does get interesting. There are many things going on at once. In your second commnent you mention aldosterone. A very cheap drug called Spironolactone is used as an autism therapy in the US

      Through its action in antagonizing the effect of aldosterone, spironolactone also inhibits the exchange of sodium for potassium in the distal renal tubule and helps to prevent potassium loss. The US DAN doctors think the change in aldosterone and other hormones is the key behind its effectiveness and do not even mention potassium/channelopathies. I think it is all about the potassium. I think autism is associated with several ion channel diseases (channelopathies). Some of which can indeed be treated. Bumetanide is the fix for NKCC1.

      The fever effect is also very interesting and I am sure if thoroughly investigated would lead to another therapy. I think it is all about fever triggering a response from the HPA-axis. TRH is released and this has a secondary behavioural effect. Note thet TRH is also actively researched as a possible epilepsy treatment.

      When looking at histamine you have to look at mast cells and then all 4 types of histamine receptor (H1, H2 H3 H4). H1 , H3 & H4 are in the brain. I guess not all people react the same way. When mast cells release hustamine they also release a whole wave of other inflamatory cytokines etc. Nobody can say for sure which combination is affecting behaviour/seizures and in what way. I think the key is to look at mast cell stabilizers, that are also H1 antihistamines. Next year I will be prepared with Azelastine (nose spray/eye drops) and Rupafin (oral) this should be the most effective way to stabilize mast cells. I will let you know it it works !

      Peter

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  2. http://www.ncbi.nlm.nih.gov/pubmed/17222915

    The above is a link to mood and pollen counts and the possible relationship to Seasonal affective Disorder, which is interestig because of links to the evolutionary theory of affective disorders. There is a link between bipolar disorder, epilepsy and autism, to do with prostaglandins.
    Interestingly the ketogenic diet is effective in bipolar disorder, epilepsy, diabetes and this is possibly to do with central aldosterone, chloride channels and GABA function and knock on effects on inflammation via insulin.
    hope this is interesting,
    regards,
    janet

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    1. Thanks, it is all intesting. There is actually a very long list of conditions that are linked to autism. I am sure if researchers thoroughly followed this up there would be valid conclusions drawn, leading to therapies. Don't hold your breath, though.

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  3. GREAT article! Thank you for posting!!

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  4. Hi Peter, do you have any idea what dosing for galantamine would look like? It seems a bit all over the map and not really weight dependent? Thnks!

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    1. There is a trial in schizophrenia now recruiting and they use 8mg a day in adults. The larger the dose, the larger the potential side effects. That trial is just for a few days, so the effect must come quickly.

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  5. Does anyone have any advice on how to tell if your child is having bad a reaction to something -- or if it is just an initial reaction ( hyperactivity/drowsiness/insomnia or other strange behaviours) that could subside in time?

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