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New Study, "Association of Antipsychotic Treatment With Risk of Unexpected Death Among Children and Youths."

According to a new study involving 247,858 individuals ages 5-24 receiving Medicaid, high doses of antipsychotic medications (more than 50mg of chlorpromazine (Thorazine) equivalents) had an 80% increased risk of unexpected death compared to a control group, "Wayne A. Ray, Michael Stein, Katherine T Murray, D. Catherine Fuchs, Stephen W. Patrick, James Daugherty, Kathi Hall et al, "Association of Antipsychotic Treatment With Risk of Unexpected Death Among Children and Youths," JAMA Psychiatry, epub (December 12, 2008): doi:10.1001/jamapsychiatry.2018.3421. The individuals in the study "had no diagnosis of severe somatic illness, schizophrenia or related psychoses or Tourette syndrome or chronic tic disorder."

The authors recommended psychosocial interventions and limiting antipsychotic treatment to "the lowest dose and shortest duration possible." Yet individuals often take high doses for long durations, never coming off antipsychotics while we make applied behavior analysis a luxury treatment, available to only to families who can pay for it. As discussed in my book, in a year, 70% of children with autism age 8 and up receive psychiatric medication despite a lack of evidence. However, applied behavior analysis has thousands of studies to show evidence and does not have side effects. Yet our society for the most part refuses to fund ABA, including for my brother Stuart who is on twenty medications including two antipsychotics. Our FDA tried to ban my brother Matthew's two second skin shock which has kept him off antipsychotic medications almost thirty years. Instead our government is choosing and trying to force others to take medications with adverse effects including sudden unexpected deaths, because our education and adult special needs programs for the most part are not funded to provide ABA.

Tens of Thousands Injuries and Death Reports Linked to Medical Devices Cleared by the FDA with Limited Testing

According to an article by the American Medical Association, an investigation found that by allowing approval for high-risk medical devices without sufficient testing through an FDA streamlined pathway, tens of thousands of injuries and deaths occurred. Yet this has not been the case for the Graduated Electronic Decelerator (GED), the skin shock device which saved my brother's life, stopped his life-threatening head banging, and has been safe. As I have stated before, I tried the device myself because I wanted to experience what my brother experienced. Medical decisions need to be based on facts, scientific evidence, not emotional arguments.

mailview.bulletinhealthcare.com/mailview.aspx?m=2018112802ama&r=6602680-11b9&render=y

Music Therapy, Autism, Social Communication and Brain Connectivity

A recent study showed that just eight to 12 weeks of 45 minute individualized music therapy improves social communication and functional brain connectivity in children with autism ages six to 12 years, (Sharda M, et al. Trans Psychiatry. 2018;doi:10.1038/s41398-018-0287-3). 51 children were randomized to the music intervention group or a non-music control play intervention without music. MRIs were performed before and after the intervention. The music intervention used musical instruments and songs, paying attention to rhythm. Both interventions tried to create shared experiences and relationships as well as foster self-expression and emotional regulation. Afterwards in the music group, brain connectivity improved in two areas. Furthermore in the auditory and visual areas of the brain which are known to be overconnected in autism, showed a decrease in connectivity.
Let's put music back in schools and certainly for individuals with autism.

US Physicians Who Write Clinical Practice Guidelines Often Have Financial Conflicts of Interest

According to two research letters in JAMA Internal Medicine, on October 29, 2018, authors including Dr. Rishad Khan examined 18 clinical practice guidelines authored by 160 doctors. 49.4 percent declared they received payment in the practice guideline or supplemental materials. 31.3% of the doctors declared they were paid from industries marketing one of ten high-revenue medications recommended by a guideline. Over a quarter of physicians received payment of a high-revenue medication but did not disclose payment.

Pharmaceutical companies give these payments for a reason. As long as this practice continues, we will never know if practice guidelines are based on research evidence or represent another form of advertising.

https://www.psychiatryadvisor.com/practice-management/financial-conflicts-of-interest-prevalent-among-clinical-practice-guideline-authors/article/811951/

Artificial Sweeteners, Autism, the Microbiome and the Loss of My Brother's Healthy Compulsive Behavior

According to recent research in animals, maternal gut bacteria may influence the development of autism by altering the immune system in pregnant mothers, (Catherine R. Lammert, Elizabeth L. Frost, Ashley C. Boite, Matt J. Paysour, Mariah E. Shaw, Calli E. Bellinger, Thaddeus K. Weigel et. al., "Cutting Edge: Critical Roles for Microbiota-Mediated Regulation of the Immune System in a Prenatal Immune Activation Model of Autism," Journal of Immunology 201, no. 3 (2018): 845-850).

In another recent study, artificial sweeteners have been found to be toxic on gut bacteria (Dorin Harpaz, Loo Pin Yeo, Francesca Cecchini, Trish H. P. Koon, Ariel Kushmaro, Alfred I. Y. Tok, Robert S. Marks et. al., "Measuring Artificial Sweeteners Toxicity Using a Bioluminescent Bacterial Panel," Molecules 23, no. 10 (2018): 2454).

Diet for many reasons in addition to the microbiome is an integral part of health. If there was one compulsive behavior that was good for my brother, it was his need to eat cantaloupe every day with dinner. I remember during a long day of residency training my brother called me at work rather anxious, there was no cantaloupe in the house. He was staying with me for a few weeks while my parents took a vacation. Even though I was exhausted after the ten to eleven hour day, I knew if I did not pick up a cantaloupe on the way home from work, it would have been much worse if I came home without one. However at his new residence, no matter how often my mother and I prompted the staff, there was often no cantaloupe there for my brother. Now that that routine is broken, he refuses to eat any fruit there at all.