A recent study examined the use of antidepressant medications which affect brain serotonin and intracranial bleeds. (Christel Renoux, Sarah Vahey, Sophie Dell'Aniello, Jean Francois Boivin, "Association of Specific Serotonin Reuptake Inhibitors with the Risk for Spontaneous Intracranial Hemorrhage," JAMA Neurology 77, no.2 (2017): 173-180, doi:10.1001/jamaneurol2016.4529. 1,363,990 individuals were studied. Medications which strongly inhibit the reuptake of serotonin into cells were associated with greater risk of bleeding. The risk is higher within the first thirty days with these medications, and the risk is higher with anticoagulants, also known as blood thinners. Individuals with autism already have neurological impairments and if there is a bleed in the brain, there is a potential for worsening of brain function.
Focusing on skills: How my brother with autism may have prevented a train accident
Last Sunday, my brother Stuart who has autism came over my home to celebrate my daughter's birthday. He lives in a residential placement and a staff from the house brought him over. The staff told me that about a year ago, at a subway station, my brother noticed there was a problem with some wheels on a train. My brother told a transit worker. The transit worker called over an inspector and it turned out the problem was dangerous. The crew had all the passengers evacuate the train and then the train was removed from the station for repair. My brother may have saved lives. Even though people have disabilities, we must develop their skills. People with disabilities can also make great contributions to society.
Autism. Overweight, Obesity, Artificial Sweeteners, Strokes and Dementia
Children with autism are more likely to be overweight or obese compared to neurotypical children (Sarabeth Broder-Fingert, Karisa Brasauskas, Kristen Lindgren, Dorothea Iannuzzi, Jeanne Van Cleave, "Prevalence of Overweight and Obesity in a Large Clinical Sample of Children with Autism," Academic Pediatrics 14, no. 4 (July-august 2014): 408-414, doi:10.1016/j.acap.2014.04.004). When individuals are overweight or obese, they may start to consume artificially sweetened drinks. However, a recent study showed that consuming such drinks is associated with an increased risk of dementia and stroke, (Matthew P. Pace, Jayandra J. Himali, Alexa S. Beiser, Hugo J. Aparicio, Claudia L. Satizabal, Ramachandran, S. Vasan, Sudha Seshadri et al., "Sugar- and Artifically Sweetened Beverages and the Risks of Incident Stroke and Dementia A prospective Cohort Study," Stroke 48, No. 6 (June 2017): doi:10.1161/STROKEAHA.116.016027). The study involved 2,888 participants. Even though the individuals are not children, children who are overweight or obese often continue to be so in adulthood. Having at least one can a day was associated with an increased the risk of all-cause dementia up to almost two and a half times as much and the associated risk of stroke and Alzheimer's dementia was almost up to three times as high. Although is not possible at this time without further study to definitively establish causation, it still is a good idea to cut back on these drinks.
Autism, Behaviors and Vitamin D
A recent double blind randomized controlled trial involving 109 subjects showed that children with Vitamin D supplementation had a significant improvement in symptoms of autism compared to placebo, (Khaled Saad, Ahmed A. Abdel-Rahman, Yasser M. Elserogy, Amira A. El-Houfey, Hisham A. K. Othman, Geir Bjorklund, et. al., "Randomized Controlled Trial of Vitamin D Supplementation in Children with Autism Spectrum Disorder," Journal of Child Psychiatry and Psychology (October 2016): doi: 10.1111/jcpp.12652. Improvements were seen in the Childhood Autism Rating Scale (CARS) in relating to people, emotional response, imitation, body use, object use, adaptation to change, listening response, visual response and general autistic impression. There were improvements in the Social Responsiveness Scale (SRS) in autistic mannerisms, social cognition and social awareness, in the Autism Treatment Evaluation Checklist in sociability. cognitive awareness and behavior, and the Aberrant Behavior Checklist (ABC) in irritability, hyperactivity, social withdrawal, stereotypical behavior and inappropriate speech subscales. although this was a small study and more research needs to be done to further validate these results, it is prudent to check Vitamin D levels and if low to ask a physician or other qualified health care professional regarding supplementation.
Side Effects of Drugs Identified After FDA Approvals
According to a recent study, involving 222 medications FDA approved between 2000 and 2010, 32% of these drugs were found to have safety risks after being on the market, (Nicholas S. Downing, Nilay D. Shah, Jenerius A. Aminawung, Alison M. Pease, Jean-David Zeitoun, Harlan M. Krumholz, Joseph S. Ross, "Theraputics Approved by the US Food and Drug Administration Between 2001 and 2010," JAMA 317, no. 18 (2017): 1854-1863, doi:10.1001/jama.2017.5150). The risks were higher for psychiatric medications, medications that received accelerated approval and near-regulatory deadline approval. The median follow-up time for the study was 11.7 years. After these medications were approved, the median time for the FDA to either withdraw the drug, issue a boxed warning or a safety communication was 4.2 years. This poses a greater concern for individuals with autism or other communication impairments, who may not be able to communicate side effects, posing an increased risk of morbidity and mortality.