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News- Page 2
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Medication : Melatonin
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Posted by Sylvia on Monday, March 29, 2004 (07:54:59)
source Melatonin - The Sleep Master
An emerging role for this over-the-counter supplement in the treatment of autism.
By Jaak Panksepp, Ph.D.
Bowling Green State University,
Bowling Green, OH
One of the most common and most troubling times we experience is when we or our children cannot fall asleep effectively. Autistic children appear to be especially prone to this problem, and in has been estimated that more than half exhibit some disturbance in sleep patterns.
This suggests some form of deficit in the brain systems that normally promote sleep. During the past decade there has been great progress in understanding the normal brain mechanisms which sustain restful sleep.
Since a great number of sleep promoting substances exist in the brain and body, any of them might be deficient in neurological condition we call autism. Here we will focus on one of the major factors, melatonin, which is presently proving to be a remarkably effective natural sleeping aid not only for restless autistic children but also their often bedraggled parents.
As many parents have already discovered, this natural sleep molecule is presently available over-the-counter at many health food stores and distributors (although the ever present danger exists that special-interests will succeed in coaxing the FDA into taking this safe and effective aid off the shelves, as has already been done for several other important supplements, most notably tryptophan).
Of course, as with any powerful and effective substance, there are certain guidelines that one should follow to maximize benefits and avoid problems. Although there are sound theoretical reasons for believing that autistic children may be manufacturing either too much melatonin (see Chamberlain & Herman, 1990) or too little, our own viewpoint has been that many kids do not secrete enough (see Panksepp, Lensing, Leboyer & Bouvard, 1991).
Unfortunately, there presently is simply not enough good data to decide which viewpoint is correct. However, the fact that melatonin can stabilize and promote normal sleep and daily bodily rhythms is presently certain. However, it is important to learn how to use this remarkably safe and powerful substance wisely.
After briefly summarizing how melatonin works in the brain, we will share some important advice in the proper use of melatonin (including when it should be given, how much should be given, and what to do if melatonin stops working, as sometimes does happen). The first thing that is important to know is that our brains contain a wonderful clock-like mechanisms that normally keeps time with about a 24 Hr. period, but its accuracy is controlled by many factors such as light (i.e.,.., day-night cycles) and various brain chemicals, especially melatonin.
This clock-like control center is situated in two small clusters of neurons at the base of the brain called the suprachiasmatic nuclei (SCN) which, as the name implies, are situated directly above the optic chiasm, the place where half the nerves from each of our eyes cross over to the opposite halves of our brains. The many output pathways from the SCN control practically all behavioral rhythms that have been studied, from feeding to sleep.
When both nuclei are destroyed, animals scatter their behavior haphazardly throughout the day instead of maintaining a well-patterned routine of daily activities. Our own natural melatonin secretions, which normally occur during the early morning hours when we have our deepest sleep, coordinates the accuracy of the SCN clock.
People who have lost their sight, and hence are unable to coordinate their bodily clock via the influence of natural day-night cycles, are able to stabilize their rhythms by taking small amounts of melatonin at exactly the same time each day. And that is really the secret to proper melatonin use--it should be given only once a day in small amounts, and the proper time is about half an hour before one's normal sleep-time.
Within our bodies, melatonin is naturally produced within the pineal gland, a glandular organ nestled between the cerebral hemispheres, that the great French philosopher Descartes once proposed to be the "seat of the soul." In that gland, melatonin is synthesized in two steps from the precursor neurotransmitter serotonin. Pineal stores of melatonin are typically released into the circulation when illumination diminishes, and may help explain why most of us sleep better when the lights are off.
During those morning hours when melatonin levels begin to diminish, birds begin to sing and we also tend to wake up, restored, to start our daily activities. It is easy to understand why lack of sleep might increase behavioral and psychological problems during the day. In addition, melatonin does a remarkable number of beneficial tasks in the body: Not only is it a powerful inducer of sleep, but it also regulates a variety of other bodily processes ranging from brain maturation to the vigor of our immune responses. It has been found to retard the growth of some cancers, and quite independently of that beneficial effect, it can also alleviate certain forms of anxiety and depression.
Most remarkably, given in the drinking water, it has increased life-span in various experimental animals by about 20%. It also helps control the onset of puberty during adolescence.
In short, melatonin exerts many beneficial effect on the brain and body, but parents are well advised to follow certain guidelines in its use as a sleep-promoting agent:
WHEN? It should be given only once a day, about half an hour before the regular sleep-time. Supplementing with additional melatonin in the middle of the night may be effective, but it is not a smart policy, for that can shift the biological clock in chaotic and undesirable ways.
HOW MUCH? Although melatonin is very safe (people have consumed grams each day for many day with no ill effects), very small amount can go a long way. Commercially available preparations usually come in 2.5 or 3 milligram (mg) tablets, and a young child should do well on a third of this amount. The higher amounts will produce deeper sleep, but the hormone may still be circulating at quite high levels in the morning, and there are reasons to believe that is undesirable.
POTENCY CHANGE? Melatonin usually does not diminish in its effects even with prolong use, but for unknown reasons, this is not the case in all individuals. If a low dose of melatonin that has been effective for some time seems to be losing its effect (i.e., tolerance is setting in), one is wiser to stop giving the supplement for a while rather than increasing the dose. Some parents seek to restore the desired effects by increasing the doses, but that only seems to intensify the tolerance process.
It is better to take a week to a month off, and then see whether sensitivity has returned. In our experience, sensitivity is usually restored in this way. Many autistic children that have been receiving melatonin on a regular schedule appear to exhibit benefits above and beyond the improvements in sleep. They are more "with it" during the day. These may be the side-benefits of the still mysterious restorative processes that sleep provides for all of us. Additional benefits may arise from the stabilization of body rhythms that may have been out of synch before the melatonin supplementation.
Although we do know that melatonin and sleep have many bodily benefits, we do not have adequate evidence about the many "hows and whys." Our knowledge of such matters has not progressed much beyond Shakespeare's speculation that the function of sleep is "to knit up the raveled sleeve of care" even though modern thinkers are more likely to suggest that "sleep restores brain neurochemistries and other bodily resources that have been depleted by waking activities."
Melatonin appears to be a prime guardian of such restorative processes, and without it, our lives become raveled indeed. It is likely that the for presently unknown reasons, the brains of some autistic children are deficient in this important chemistry. If so, early supplementation with this hormone may be essential for normalizing development.
Unfortunately we know little about such matters, and only future research can give us the answers that we desperately need now.
Chamberlain, R.S., & Herman, B.H. (1990) A novel biochemical model linking dysfunction in the brain melatonin, proopiomelanocortin peptides, and serotonin in autism. Biological Psychiatry, 1990, 28, 773-793.
Panksepp, J., Lensing, P., Leboyer, M., & Bouvard, M.P. (1991) Naltrexone and other potential new pharmacological treatments of autism. Brain Dysfunction, 4, 281-300.
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Medication : Two drugs for autism
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Posted by Sylvia on Sunday, February 22, 2004 (02:16:12)
News 8 Austin 21/02/2004
Autism is a complex developmental disability that typically appears during the first three years of life.
It is the result of a neurological disorder that affects the functioning of the brain.
The most recent statistics show autism affects between one and three of every 500 people. Autism is four-times more prevalent in boys than girls and knows no racial, ethnic, or social boundaries. Family income, lifestyle, and educational levels do not affect the chance of autism's occurrence.
Researchers say autism is becoming more prevalent. According to the U.S. Department of Education, autism is growing at a rate of 10 percent to 17 percent per year. At these rates, the ASA
estimates that the prevalence of autism could reach 4 million Americans in the next decade.
Autism is a spectrum disorder. The symptoms and characteristics can present themselves in a wide variety of combinations -- from mild to severe. Although autism is defined by a certain set of behaviors; children and adults can act out any combination of behaviors at any degree of severity.
Autism is a lifelong disorder that makes social interaction and every day communication difficult. Some autistic behaviors may include: resistance to change, having difficulty expressing needs, repeating words or phrases in place of "normal" language, showing distress for reasons not apparent to others, preferring to be alone, showing little or no eye contact, inappropriate attachments to objects, having no real fear of danger, experiencing difficulty communicating with others and being oversensitive or undersensitive to pain.
Aggressive behaviors can be a problem for many individuals with autism. These behaviors may include verbal outbursts, biting, scratching or running away.
Researchers say there are ways to control these behaviors. One drug, called risperidone, reduces irritability in about 57 percent of children with autism. Another class of anti-seizure drugs can
help too. These include depakote, tegretol, gabapentin, and lamictal.
Researchers also say high blood pressure medications show promise in easing autistic aggression, although they are not certain why.
"There's no cure for autism, but by utilizing medications to target specific symptoms, we can improve behavior, we can improve
global functioning, and that can be very gratifying," said Dr. Eric Hollander, from Mount Sinai School of Medicine.
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Medication : Curbing autistic aggression
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Posted by Sylvia on Sunday, February 15, 2004 (13:22:32)
WIS TV 12/02/2004
By Dawn Mercer
Statistics show at least one in every 500 children is born with autism. Doctor Eric Hollander says incidence of the complex disorder is on the rise, "It consists of social difficulties, speech and language problems, a narrow, restricted interest and repetitive behaviors. Sometimes these individuals also have problems with impulsive or aggressive behavior."
Michael Himmelfarb's aggression was a constant source of worry for his dad and mom, Andrew and Emily, "He would bite. He would scratch. He would run away."
They found help in the drug Risperidone. Research shows it reduced irritability in 57 percent of children with autism, "He wasn't biting after he took the medicine, started taking it."
Dr. Hollander says another class of drugs, anti-seizure medications, can help too. These include Depakote, Tegretol, Gabapentin and Lamictal, "So, less outbursts, less explosiveness, less self-injurious behavior."
Researchers also say, though the reasons are unclear, high blood pressure medications show promise in easing aggression, "There's no cure for autism, but by utilizing medications to target specific symptoms, we can improve behavior."
Andrew Himmelfarb says he'll never stop looking for more ways to make Michael's life even easier, "I never will give up. How can I? He's my child."
Currently there are no FDA approved drugs to specifically treat autism.
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Medication : Caution Urged on Anti-Psycotic Drugs
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Posted by sylvia on Wednesday, January 28, 2004 (19:16:24)
AJC.com 27/01/2004
By Malcolm Ritter
People taking certain drugs for schizophrenia, manic-depression, autism, dementia or several other psychiatric disorders should be carefully watched for signs they are developing diabetes, obesity or high cholesterol, four medical societies say.
The recommendation follows recent studies that link those potential side effects to certain anti-psychotic drugs.
The statement deals with six now available in the United States: Abilify, Clozaril, Geodon, Risperdal, Seroquel and Zyprexa.
The recommendation, released Tuesday, comes from the American Diabetes Association, the American Psychiatric Association, the North American Association for the Study of Obesity, and the American Association of Clinical Endocrinologists. It appears in the February issue of the journal Diabetes Care.
The medications differ in their risks of promoting the various side effects, the statement says. So a patient who develops a problem with one drug can be gradually switched over to another drug with less potential for that problem. For example, a switchover should be considered if a patient has a weight gain of 5 percent or more, the statement says.
Obesity and diabetes, like high cholesterol, raise a person's risk of heart disease.
The recommendation says doctors should screen patients before starting them on such a drug or as soon as possible afterward, noting such things as a history of obesity and diabetes in the patient and the family, and the patient's weight, blood pressure and cholesterol levels. Doctors should also monitor the patient once therapy has begun.
Patients and family members should be informed of the potential for the side effects, and be told of signs of diabetes and especially those of a life-threatening complication called diabetic ketoacidosis, the statement says. That complication is marked by such symptoms as weight loss, nausea, vomiting, rapid breathing and dehydration.
That complication has appeared in some people using anti-psychotics, and it was an early tip-off that the drugs might be linked to diabetes.
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Medication : Naltrexone
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Posted by sylvia on Saturday, January 17, 2004 (11:54:57)
Naltrexone blocks the action of endogenous opioids at opiate receptors; endorphins are opiate-like substances in the brain and are associated with pleasure (e.g., runners' 'high,' sexual activity) and/or an anesthetic-like feeling.
One theory states that autistic individuals have too much beta-endorphins in their central nervous system. This theory goes on to posit that naltrexone blocks the action of opiate receptors, and thus, reduces the level of endorphins.
Some of the improvements noted in autistic individuals who have taken naltrexone include: increased socialization, eye contact, and general happiness; normalized pain sensitivity; and a reduction in self-injury and stereotypic (self-stimulatory) behaviours.
There are no known side-effects of naltrexone although possible long-term effects are difficult to assess given the relatively short amount of time since naltrexone has been used for autistic individuals.
However, there is one report that some vision loss may occur when naltrexone is given with Haldol. In addition, naltrexone may intensify social problems when given to people suffering from schizophrenia.
Naltrexone is listed in the Physician's Desk Reference (PDR) and is an approved treatment for substance use disorders such as heroin addiction and alcoholism.
Since it is listed in the PDR, physicians may use their own judgment in deciding whether to prescribe naltrexone to other individuals, such as those with autism.
Dr. Jaak Panksepp of Bowling Green University, one of the leading investigators into the effects of naltrexone on lessening the symptoms of autism, feels that those individuals who cry rarely, lack pain sensitivity, and enjoy eating hot and spicy food may benefit most from naltrexone.
If you would like to obtain more information about naltrexone, you may want to contact Dr. Panksepp at the Department of Psychology, Bowling Green State University, Bowling Green, OH 43403-0228
source: Center for the Study of Autism
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