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Living with Autism

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July 15, 2011

Can Nicotine Help Autistics with Self-Injurious Behavior?

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Can Nicotine Help Autistics with Self-Injurious Behavior?

According to research, nicotine may help autistic persons. Why? Nicotine acts on nicotinic acetylcholine receptors in brain, most notably the ganglion nicotinic and CNS receptor. When the brain is deficient in acetylcholine, cognition declines, thoughts get stuck, frustration rises. Increasing acetylcholine may reduce these symptoms. Nicotine also increases dopamine and norepinephrine in the brain, which aids learning, concentration, memory and relaxation. Moreover, research shows nicotine may repair damaged myelin sheath in autistic brain. The challenge treating severely-autistic persons with nicotine would be mechanism of delivery.

Smoking cigarettes elevates acetylcholine, but we know smoking is not good for your health. Besides, my son wouldn’t know how to smoke. An alternative to smoking is Transdermal patches to deliver nicotine to the autistic person suffering from self-injurious behavior.

How do you diagnosis depleted choline in the brain? Usually by doing a fMRI (functional magnetic resonance imaging). My son’s last fMRI showed “blunted choline.” Could deficient choline in his brain be thwarting efforts to treat his self-injurious behavior? After all, if you are in a constant brain fog, no matter how many behavioral interventions, vitamins, herbs or exercise therapies you use to treat SIB, the brain is impaired by this chronic lack of choline.

Of special interest is the fact anti-epileptic drugs DEPLETE acetylcholine. Up to 30% of autistics suffer from some kind of seizure disorder.

What’s more is use of anti-psychotics in treating challenging behaviors in autism often causes severe side effects, which trigger more self-injurious behaviors. For example, Tardive Dyskinesia, a disabling brain disorder caused by failure of the brain cells to release acetylcholine and causing involuntary body movements. Tardive Dyskinesia is routinely treated with choline and Lecithin. However, bacteria in some individuals break down choline. As a result, the choline is rendered ineffective and you will smell like a dead fish,” writes Gregory Gore, author of “Defeat Cancer.”

According to the Keefe Clinic, the hormone DHEA can boost levels of acetylcholine. Huperzine-A is another natural supplement said to raise levels of acetylcholine, thus improving memory. China appears to be the leader in studying Huperzine A.


Vitamin B-5, also known as pantothenic acid, is important for the synthesis of acetylcholine, according to the Linus Pauling Institute at Oregon State University. Foods containing choline include wheat germ, kidney beans, egg yolks, Atlantic Cod, beef, salmon, peanuts, cabbage and broccoli. Additional research suggests amphetamines increases acetylcholine release via a complex neuronal network rather than simply increasing basal forebrain D1 (dopamine 1) or D2 (dopamine 2) receptor activity. Yet another reason to consider low dose amphetamine with low dose SSRI, as a possible adjunct in the treatment of self-injurious behaviors. Lastly, THC, found in medical marijuana is said to elevate acetylcholine.

So, as I once again frantically research better treatments for autism and SIB, I find myself asking if my son’s doctors will be open to trying nicotine and/or medical marijuana for my autistic son’s self-injurious behaviors. How long will I have to wait for an answer? How many appointments, consults and evaluations will it take? Will I have to go to battle again? Why is everything a fight? OR should I just go to Wal Mart and buy nicotine patches? And get a medical cannabis card for my son? As of today, his ANGIOEDEMA caused by Abilify, Geodon and Risperdal is under control. Or was it an acute dystonic reaction? Or both? His tongue appeared to be twitching, which caused him to stop eating and drinking. Also, he presented with neck spasms. He was also gagging when he tried to swallow his food. A few days ago, a doctor gave him a steriod injection, to treat suspected angioedema. That reduced swollen adams apple he had, but his tongue was still rolling around in his mouth and twitching in weird ways we've never seen. And his neck still seems rigid (torticollis?). Just horrifying. God, I hate anti-psychotics, but at least now we can say we've exhausted the list of anti-psychotics and there is NO doubt he is hypersensitive to these medications, as I suspect many autistics are, which raises the question of seriously exploring alternatives like medical marijuana and nicotine patches.

My son is at doctor’s office now with his home health nurse and my mind is racing. I’m on a roller coaster of emotions again. Thrown into that familiar panic mode, until I feel I have at least found two more ways I may help my child—a child who is now a young adult. Will we ever find a cure to this self-abuse? Will doctors ever properly identify and treat what is fueling this behavior? I know it’s difficult for them. My son is a very complex case. Is his SIB rooted in gastrointestinal issues? Brain functioning? Choline deficits? Are we missing something? Why is my son’s self-injurious behavior so difficult to control? How is it that he can go days without SIB, but then have a spontaneous remission? Could it be rooted in a lack of acetylcholine in the brain which cancels out all the vitamins, herbs, exercise and behavioral therapies we try to eradicate self-abusive behavior? How do we effectively treat the “blunted choline?”

Nicotinic acetylcholine receptors: That’s where my mind is stuck. Am I thinking in the right direction? God give me wisdom. Now, doctor is admitting him to hospital, he’s having some kind of extra-pyramidal reaction to prescribed Abilify again, though Abilify did seem to reduce his self-abuse last week.…. I need to get him off all these meds, but if I do, he may have more seizures, so then what? Do we continue to use anti-psychotics are a rescue medication and then piggy-back it with cogentin and/or benadryl? Or do we just say forget the darn anti-psychotics, let’s restore choline levels in the brain so he isn’t in a constant brain fog? I’m waiting for psychiatrist to call me back. I haven’t heard from the neurologist. The internal specialist did not want to discuss blunted choline. He was more concerned with treating the tongue edema and tremors, which is fine, but that leaves us waiting again. A social worker from hospital called, but she didn’t know what I was talking about when I mentioned blunted choline, nor do I expect her to. All she wanted to know is if we wanted to place our son in a psychiatric unit and I said no way, because “all they do is push anti-psychoticsl” He’s not psychotic. He’s severely-autistic. His brain is deficient in choline. He’s probably in a chronic brain fog. If choline is linked to impaired learning and memory, it is logical to assume that blunted choline is hindering his progress. Ironically, three months I did go to health store and buy Huperzine A, and we saw a dramatic increase in eye-contact and focus. How long does it take to restore choline in the brain? And if he’s on daily seizure medications, wouldn’t that be constantly depleting the choline, leaving us in a constant battle to balance the brain? Surely, there must be a way to bring hope, healing and help for my son. As in common with families raising autistic children, it’s back to research. UPDATE: 8/5/11: Son's self-abuse radically reduced after only two days on nicotine patch. Won't get too excited, though, for now, since we've been disappointed so many times, we will wait for another month to really celebrate! Meanwhile, research looks very promising in using nicotine (no, not cigarettes) in the treatment of autism and challenging behaviors and even in autism for general improvement of brain health. I'm so glad I found this research. I never would've thought of nicotine, until I stumbled across the research on nicotine and autism. Maybe God is listening to our weary prayers after all....



Nicotinic receptor abnormalities in the cerebellar cortex in autism.

1.                              brain.oxfordjournals.org/content/125/7/1483.abstract
2.                              Brain. 2002 Jul;125(Pt 7):1483-95.
3.                              Brain research Molecular brain research (2004)
            Volume: 123, Issue: 1-2, Pages: 81-90
                  PubMed ID: 15046869
4.       Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710
  1. Findings point to dendritic and/or synaptic nicotinic receptor abnormalities that may relate to disruptions in cerebral circuitry development
  2. http://www.livestrong.com/article/404115-how-to-naturally-increase-acetylcholine/#ixzz1LvRO9Jmf
  3. http://www.scripps.edu/news/press/080906.html
Source: Amphetamine-stimulated cortical acetylcholine
release: role of the basal forebrain
by Arnold HM, Fadel J, Sarter M, Bruno JP.

July 2, 2011

Autism and Medical Marijuana

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Medical Marijuana and Autism: Is it Worth Trying?

Yes, but with extreme caution. 

Medical marijuana (MMJ) isn’t always safe for people with autism. Mainly, because nobody is checking the potency or validity of the strain you can get at a dispensary or from wherever you get your strains. 

There are hundreds of different cannabis strains. HUNDREDS!
Thus, it is IRRESPONSIBLE for people to blindly claim that medical cannabis helps people with autism. How do you know which strain helps people with autism? You'd have to analyze each strain. Not everyone is using the same strain of cannabis. There are some strains very high (pun intended) in THC. No bueno for people with autism and epilepsy. 

Some people who ingest certain MMJ strains high in THC may develop ticks or twitches upon smoking cannabis. Hence, you don't tell others "cannabis is great for autism." Very reckless. And ignorant. Do your research. 

Medical marijuana smokers call twitches that you can get from cannabis “kibbying.” Here’s an example of an anecdotal report from someone on a marijuana board on net: “It's 9:30pm, I have 4 pages left to go on a paper that’s due in 12 hours. FUN! So what do I do, I get higher than I've been in a long time! Bad idea...I know, but the point is that right now I’m twitching. I always twitch when I get REALLY stoned…” 

Sounds like this student should've tried a strain higher in CBDs or immediately smoked a strain high in CBD to counter the effects of the higher THC strain. But that's something a DOCTOR should be overseeing. A doctor through your insurance who can prescribe an FDA approved cannabis medicine that has been TESTED for authenticity. Not some bag of weed you picked up from a buddy or at a dispensary. 

Here’s another post on same website from ANOTHER person who got twitches from MMJ. “I got twitching for the first time a while back (after getting very, very high), and it kinda scared me. Really quite bad in my legs and arms, for about 15 minutes. Uncontrollable. Strange. Can't say much more besides I've been there before, but if anyone has an explanation for that, I'm all ears...” Source: http://www.marijuana.com/medicinal-marijuana/2612-ahh-twitching-horrendus-twitching.html



Apparently, Medical marijuana (MMJ) comes in 3 strains: Indica, Sativa and Hybrids. Hybrids are a mix of both and are either “indica dominant” or “sativa dominant.” Example: A Hybrid could be 70% Indica/Sativa 30%  or 70% Sativa/Indica 30%

Sativas: Many MMJ users report sativa strains have anti-depressant affect, treat chronic pain, increase focus and enhance creativity.  

Sativas are higher in THC. MMJ users further report sativas good for low grade pain, anxiety, nausea, energy and body buzz. Apparently, a body buzz feels good. Unclear if “body buzz” would scare or comfort an autistic person. I noticed users report MMJ sativas as having side effect of “clear head” or “fuzzy.” Good information, as I would not want to use a MMJ strain for my autistic son that caused fuzzy thoughts. We’re aiming for clear, calm, happy thoughts here.

Indica strains: Reported to be more sedating, used for acute or chronic pain, muscle relaxing, insomnia, nausea and anorexia. Some indica strains stronger than others. Marijuana users describe stronger strains causing “couch lock.” This means you are so high you apparently sit on a couch and can’t move. Doesn't sound fun. However, if you're an autistic person pounding yourself in the head, and nothing is working to stop this dangerous behavior, this could be a reasonable, safe option. 

Hospitals routinely use Thorazine, Haldol, Ativan and Zyprexa to "couch lock" an out of control patient--- basically knocking them out cold, so why not heavy dose of cannabis for a patient having a behavioral crisis, right? Right, but the problem still remains that there's NO FDA approved cannabis yet that can do that. So, why not focus on pushing the FDA to approve medical cannabis? Why not support medical cannabis research? 


Research shows human brain has Cannabinoid receptors. CB1 receptors target hippocampus, limbic system and basal ganglia and have anti-convulsive effect. CB2 receptors are found in immune system and have an anti-inflammatory effect

As per research, it appears strains HIGH in Cannabidiol (CBD) would be the more medically sound strains. Strains high in THC increase social anxiety and isolation, clearly not what you want for severe autism. Cannabidiols also act on 5HT1a receptor, which is a receptor targeted by antidepressant drugs and leads to the uplifting, pain modulating effect.

So: Cannabis sativa is higher in THC. Cannabis Indica is higher in CBDs. 

 Based on research, it doesn't seem logical to give strains high in THC to an autistic person with epilepsy. 

THC can cause hyperexcitability in brain. NOT good for epileptics.  

For a good video that talks about strains high in CBDs, I found this: www.youtube.com/watch?v=qroKHwQEVl8


Also this website has info: http://projectcbd.org/

Let's be truthful: HALDOL, Risperdal, Zyprexa and other powerful anti-psychotics, have done more harm than good to the autistic population. They are DREADFUL drugs. Toxic. 

Surely, it would behoove autistic patients with serious behavioral and medical issues to have access to medical cannabis with high levels of CBD’s.
Medical marijuana is also used to as an appetite stimulation for autistics and other challenged individuals who are HIGH RISK for suffering serious medical problems and might need a G-tube (gastrostomy tube) because they won't eat.


HOW does MMJ interact with frequently prescribed medications, such as Prozac? Nobody really knows. Yet, IF sativa strains target serotonin receptors, for example, might ingesting pure sativa or sativa dominant strains risk triggering “serotonin syndrome”? And, if INDICA strains are thought to elevate dopamine, might someone on a dopamine elevating pharmaceutical be at risk? Too much dopamine can trigger psychosis.

Consider one study that showed Schizophrenics given cannabis strains high in SATIVA (the strains most likely to raise serotonin levels) had LESS schizophrenic symptoms. WHY? Drugs that increase serotonin decrease dopamine. 

By reducing dopamine in the schizophrenic brain, you could, theoretically, lessen symptoms. 

Too much dopamine=schizophrenic behaviors. TOO LITTLE dopamine=Parkinson’s disease.


In a study by Pamela DeRosse at Long Island’s Feinstein Institute for Medical Research, schizophrenics who smoked cannabis “had faster brain processing speed, greater verbal ability and better memory than patients who didn't smoke”. Studies show there are "clinical and biological links between autism and schizophrenia." Thus, what worked for the schizoprenic patient, may work for someone with autism. 

However, the study fails to show which marijuana strains were smoked, which is important information, since different strains target different brain receptors.

Warning on using medical marijuana with autistic people: too much THC (9-tetrahydrocannabinol), an active ingredient in marijuana, can cause hallucinations, paranoia and psychotic episodes. 

Yet, there’s something called cannabidiol (CBD) in select strains that reduces and even reverses THC induced psychosis. 

Strains high in Cannabidiol (CBD) supposedly have anxiolytic and antipsychotic effects. 

It would seem logical then to consider marijuana strains HIGH in CBDs and LOWER in THC for an autistic patient. 

Of course the entire idea of medical marijuana for my autistic son is a odd, as I’ve always hated pot. 

The idea of smoking something that makes you hungry and slows your cognition never appealed to me, but I can see how people who are in pain or suffering could benefit from it. 

Also, when you’ve witnessed Haldol causing your child to go into retrocollis and have a olygiric crisis, you start to look more favorably at medical marijuana. I will never forget what Haldol did to my son. It was as if someone had assaulted him with a toxic chemical. Anti-psychotics are CONTRAINDICATED for patients with autism. They are largely ineffective and cause serious side effects. Alas, what the heck do you do then when a person with autism is having a behavioral crisis? Or having seizures? Well, you go to cannabis. I totally get it. I understand how parents would feel so desperate, hopeless and angry that their child wasn't getting effective treatment that you would get that cannabis card and think it's all good from here. But don't be fooled. NOT ALL cannabis helps people with autism. It is the responsibility of people advocating for medical marijuana and autism to do their research and educate people about which SPECIFIC strains worked for your child and why. Don't just say, "my kid used medical marijuana and now life is groovy." That's low level shit. Elaborate. 


Still, I’m concerned about how MMJ could trigger seizure activity. Nobody knows why. This is my theory: when the CB 1 receptor is activated by marijuana, it may inhibit GABA release. GABA is what helps quell seizure activity, so if GABA is inhibited, couldn’t that lower seizure threshold? 

And the more smoked or eaten, the more GABA it would inhibit, thus this explains people reporting they get twitches when “really high.”

Interestingly, some people mix smoking marijuana with taking valium, as if they are self-medicating. Valium increases GABA in the brain.

Here’s what one person said on another marijuana site on net: “get this when I smoke and even when I'm sober, I get random twitches which I never had before.”

Don't know why, but when I pop a xanax before smoking, the twitches don't come. Actually, they don't come at all when I'm on pills.” Source
: http://www.bluelight.ru/vb/archive/index.php/t-103795-p-4.html.   (Xanax elevates GABA in the brain)

These random pot heads don't realize they are self-medicating against myoclonic seizure activity induced by the most likely high THC cannabis.
. 

How would you give medical cannabis? 

Most severely-autistic persons can’t or won’t smoke marijuana, so the mechanism of delivery becomes eating marijuana, which can have a different effect on the brain. For one, when eaten, the onset, peak and duration of marijuana is a lot longer than if smoked.  

Secondly, according to cannabis doctors, cooking with marijuana can deliver unequal and more powerful doses if not done correctly. 

Once you get a prescription, you can go to Dispensaries to find medical cannabis food to give your child. They are called, "edibles."


Evidence showing the mechanism of action of specific marijuana strains is LACKING. Not good. 

If indeed certain cannabinoid receptors are targeted and do DIFFERENT things, than it’s critical to KNOW which strains act accordingly on receptors in order to prescribe that strain for medicinal purposes! 

Perhaps there is no big push in MMJ community to do this, because too many people don’t give a rat about the medicinal purposes and are only there to get high, as seen in the long lines of perfectly healthy 20 yr olds entering marijuana dispensaries. 

Oh well, maybe they have a headache and advil just doesn’t quite do the job. It’s none of my concern, I’m just concerned about if it can help my autistic son not smash his fists into his head. And have less or no seizures. 


Other things you may not know about medical marijuana:

1.              Synthesized THC is known as dronabinol  or Marinol and sold as a schedule 3, prescription drug
2.              Synthesized THC is not very effective
3.              SATIVEX is an FDA approved drug derived from cannabis plants
4.              Sativex more effective since it has higher CBD
5.              Mechanism of delivery for sativex is oromucosal (sprayed in mouth), which could serve as a great rescue medication, if it works, for self-injurious behavioral meltdowns
6.              Pharmaceutical companies have already entered into exclusive marketing agreements for Sativex
7.              Sativex is marketed in Canada by GW Pharmaceuticals
8.              There are female and male cannabis plants. Females are supposedly higher in the good CBDs that help epilepsy, dystonia, etc…
9.              Endocannabinoid system in brain is responsible for maintaining homeostasis. MMJ targets these receptors
10.       Retired law enforcement officials are rumored to be involved in the medical marijuana business. Guess retirement packages aren't too good these days.

http://www.abqjournal.com/639091/former-sheriff-now-a-director-of-nonprofit-in-medical-pot-business.html