Archive for December, 2011

Stimming in Autism

Dec 05 2011 Published by under Asperger's,Autism,Highly Sensitive Person,HSP

Stimming in Autism, problem and solution in 2 minutes from the author of Psyche-Smart Autism book.

Stimming in Autism

Rami Serhan, MD
consultant@sovereignresearch.org
Sovereign Research, LLC

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Risperidone, Autism and Timothy Leary

Dec 04 2011 Published by under Asperger's

This post is about the use of risperidone in autism; its possible benefits and drawbacks. It seems everyday, in the course of my consultations, one or more clients bring up the use of risperidone (and abilify) in autism. I feel the tide is flowing further and further inland and I am concerned. Is it safe and is it appropriate to load autistic kids with anti-psychotics.
I have been on this trail for a while and all I hear from physicians is how risperidone calms autistic kids down in ways that no other treatment modality can. Of course this is pleasing to all parties involved since many parents feel overwhelmed (and embarrassed) with their child’s seemingly bizarre and even threatening behavior. Risperidone takes all that away and replaces it with a docile demeanor which puts everyone at ease.
No one is asking the question of what is the value of these disorganized outbursts that many autistic children manifest. No one is asking why a child who usually keeps to herself indiscriminately, suddenly turns into this outwardly child who is threatening others.
I hear the speculations and insinuations that autistic children are inherently violent and they need schizophrenia drugs to make them peaceful. However, this is just an uneducated interpretation of the events. Think of it this way. Mainstream doctors who know little about autism are compelled to present parents and care givers with answers to questions they really have no answers for. Ego and good business would have it that doctors go to a familiar place where they have answers, schizophrenia. Unfortunately it is like traveling to a foreign country where you do not know anyone and can’t understand the language. Feeling overwhelmed and powerless, the natural reaction is to find similarities in this foreign land to one’s own neighborhood. This shopkeeper looks awfully like steve, our neighbor from back home; you might think. Let us go talk to him. Soon you will find out that this shopkeeper is nothing like steve your neighbor and that you are still in the same lost state. But meanwhile you feel better just finding some anchor to hang your hat on.
This is the sad state of affairs in autism today. Autism is not schizophrenia or psychosis of any kind. Autistic children are not inherently violent and they are fully in touch with reality. They just do not possess the proper means to express themselves in a socially acceptable manner.
Now, let us go from general statements to more specific exploration of what risperidone does and how it falls short, and is even counterproductive. To get there I need to define serotonin, a neurohormone. Serotonin is a hormone present in all living human beings and among its roles is to make us feel in control of our immediate environment. It gives us the motivation to manipulate our vicinity in a favorable way. This is a common human tendency. We all like to feel safe and dominant in our homes, jobs, relationships etc…
Once serotonin works on its receptors in the brain, it enhances this feeling of wanting to do something to bring order to our vicinity. Serotonin is an especially important player for someone who feels out of control; someone who feels she cannot influence her own behavior or make others act in a way that keeps her in control. In other words, it is a badly needed player in autism.
Risperidone, among other things, blocks a crucial serotonin receptor (5-HT2A) involved in attempting to gain control over one’s life and day and room and so on. By blocking this serotonin receptor, risperidone blocks any actions that serotonin normally provokes. This makes autistic children docile but feeling more out of control than ever. It denies them the opportunity to learn how to dominate their vicinity and bring control and order to their environment.
We all start out not knowing how to manipulate our environment to our advantage and through trial and error we learn to do that. We learn to get our friend or partner or co-worker to respect our individuality and our preferences. However, if one is never given the chance to try to gain such control, then how is this person going to learn. Risperidone is used in psychosis to prevent senseless violent outbursts that characterize many schizophrenics.
However, in autism, risperidone is being used to prevent children from learning how to behave in matters that are crucial to their stability, functioning in society and gaining independence eventually. Autistics do not have violent outbursts, they have failed attempts at getting people around them to respect their preferences and comply with their wishes. A wise parent or care giver has to cherish these tantrums (yes cherish) and try to shape them and orient them into more socially accepted behavior. I thought this is what parents are supposed to do; teach their kids manners and skills to prepare them for life as independent adults. But what do I know; maybe the right parenting method is to create a dependency in the child that makes her helpless and permanently unable to take care of her own affairs. This way when she grows up, we can put her in a home or asylum where a professional perpetuates the same dependency for a fee. As a healthcare professional, this is good business because it is long term business with no end in sight. But as a parent, I hope you can see where this is going.
When did a ten year old become so dangerous as to pose physical threat to a fully grown adult. He or she is not, but it seems society now wants the look and feel of docility and conformity at any price. As a parent, can you afford this price?
All of the above was about the downside of using drugs to “control” children. But what about some constructive research. Back in the late fifties and early sixties a crazy crazy man named Timothy Leary, got his hands on some fascinating mushroom extract from a european pharmaceutical company called Sandoz. This company is now known as novartis. Anyway, this mushroom extract contains a naturally occurring chemical called psilocybin. This chemical was the center of some of the experiments that got Leary and his associate, Richard Alpert (or Ram Dass) fired from Harvard. As it turns out the research on psilocybin was threatening the authoritarian rule in society because it was making people want to explore their purpose in life and motivated them to fulfill this purpose. Obviously in a society that seeks conformity, glorifies docility and despises individuality and original thinking, psilocybin was a clear threat. We all know the rest of the story. The point is, fifty years ago, some enlightened scientists were finding a way for autistic children to explore their own inner self and to get the motivation needed to get out of their shells and join the ranks of productive and independent society. I am not sure that Leary and Dass knew that but they were on to something. Since these mushrooms and LSD are banned substances now, we as a community responsible for autistic children, have to find ways to improve and increase levels of serotonin in autistic children in order to allow them the opportunity to find their path in life. We also have the responsibility to educate parents about behavioral means needed to bring their children from isolation to independence.

Rami Serhan, MD
Founder, Sovereign Autism Research
(206) 659-1ASD (273)
consultant@sovereignresearch.org

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