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Living with Autism


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.

1 comment:

LokaSamasta said...


This is interesting, I stopped injuring myself when I started smoking but I never made the connection.

Round about the same time as I started smoking I also finished being post-pubescent which I thought was the reason for no longer having any SIBs.

I have heard of one high functioning autistic person who has his cigarettes bought for him by an autism charity.

Sadly that same charity were not interested in paying for my cannabis!

If the following ever run out of cigarettes, run away:
1) Your side in a war
2) The mental hospital you are currently visiting.

Rightly or wrongly, cigarettes cannot ever be banned, that would cause a mass murder-a-minute!

Since I smoke tobacco, I am able to use it as a base for smoking cannabis. It also serves as an anxyolitic to attenuate the psychomimetic effects of the THC if I cannot get cannabis with enough CBD in it.

Either way, smoking pure cannabis does not work as well (for helping to manage my asperger's), eating it certainly does not give enough dose control.

My doctor has measured my lungs and genuinely does not believe I smoke anything!

The anti cancer properties of the cannabis seem to keep the cancer causing effects of cigarettes at by (Taskin et al).

Again, thank you for blogging this :)


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