'I-28Sfuuy-WR10okMSia3VYeZTm2RHA2LZDel59TlF8' name='google-site-verification'/>www ghs.google.com 6dseurqgapmn gv-v6egtfduggmq3k.dv.googlehosted.com Autismwarriormama: Choline and Autism: Why Nicotine Patch May Help

Living with Autism


August 26, 2011

Choline and Autism: Why Nicotine Patch May Help

Nicotine Patch is a unique way to elevate dopamine and acetylcholine in areas of brain—areas that boost learning, language and mood.

Anyone living with severe autism and challenging behaviors knows the value of better moods. Better moods=better behavior. Better behavior=better focus. More focus= more learning.

Exactly why nicotine seems to help my autistic son has become an obsession, as if answer is a secret treasure and I can’t stop digging. Not that nicotine therapy is a secret, but it may as well be, as it is rarely discussed, studied or prescribed in behavioral or medical management of severe autism.

So little is known about nicotine therapy for autism, it was hard to convince doctor to prescribe it. It all began the Summer of 2011. I refused to sign the discharge papers until I spoke to ANOTHER doctor. They weren't sending my son home AGAIN, in a continuous self-abusive meltdown. I waited. And waited. I paced hospital ward. I bugged nurses. Finally, I get a call. I BEG the on-call doctor to prescribe Nicotine Patch before my son is discharged.

(He had been admitted for an acute adverse reaction to anti-psychotics. He was a physical and emotional mess. I was desperate.) I Had just poured over research for hours, wondering what the hell we were going to do now. “We’ve got nothing to lose,” I told doctor.

“Nicotine elevates choline and his brain needs choline.” It was a grab in the dark. I wasn’t sure nicotine would help. All I knew was nicotine elevates a neurotransmitter (acetylcholine) shown to be blunted in my son’s fMRI. And that Choline in brain is critical for cell communication and function. That’s why it’s added to baby formula and critical part of pre-natal care. It’s also why Alzheimer’s researchers are analyzing nicotine therapy as a novel, emerging treatment. Why autism research isn’t looking closely at nicotine is unclear.
What is clear, in my opinion, and from our personal experience, is the nicotine transdermal patch is a potential NEW and EFFECTIVE therapy for helping autistics suffering from intraccable self-injurious behaviors.

Especially, when there is evidence (like from my son's fMRI) of acetylcholine dysfunction. How many autistics suffer from acetylcholine dysfunction? Nobody knows.

Is severe autism associated with a deficit of acetylcholine? Research shows it is. Can drugs given to autistics deplete choline? Yes. Or is there an enzyme dysfunction in autism that thwarts choline converting into acetylcholine? Research shows it's possible. Don't expect your doctor to know this, by the way. The only way you can check is with brain scans, which almost no psychiatrist does before prescribing a drug that alters neurotransmitters in your brain. Wouldn't it be wise to KNOW what the brain needed before prescribing medication? Otherwise, you're just guessing. Sure, the brain scan may not give you an absolute picture of what's going on, but it's better than NO picture of what's going on and introducing drugs with no target goal in mind. It was pretty clear to me: fMRI shows blunted choline, I need to get more choline into my son's brain. How do I do this? (Galantamine is another way to increase acetylcholine in the brain. )

To test if increasing choline in your autistic child’s brain helps, you can always increase choline rich foods. If you note improvement, this provides evidence for doctor to consider nicotine therapy for possible choline-deficient fueled problem behaviors.  Average person needs about 500 mg of choline a day. Following foods rich in choline:

1.    Eggs. Don’t worry about cholesterol. I have never understood the tired mantra of “don’t eat too many eggs.” Egg yolks have lecithin. That means it doesn’t matter how much fat is in the egg, because lecithin is a fat emulsifier. One egg has about 125 mg of choline.

2.    Fish. Cod has about 71 mg per 3-oz. Salmon about 55 mg and Shrimp about 60 mg.
3.    Liver. Highest amount at 355 mg per 3-oz serving. Yuk. I’d rather eat 3 eggs.
4.    Broccoli.
5.    Avocados
6.    Apricots
7.    Figs, dates
8.    Bananas
9.    Spinach
10 Cashews
11. Wheat Germ
12. Orange Juice

Here's SOME of the research I did in July 2011, to justify trying Nicotine Patch for self-injurious behaviors in my severely-autistic son: 


Nicotinic receptor abnormalities in the cerebellar cortex in autism.

1.                              brain.oxfordjournals.org/content/125/7/1483.abstract
By binding to nicotinic acetylcholine receptors, nicotine increases the levels of
several neurotransmitters - acting as a sort of "volume control". It is thought that ...

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 in cerebral circuitry development
  2. http://www.livestrong.com/article/404115-how-to-naturally-increase-acetylcholine/#ixzz1LvRO9Jmf
  3. http://www.jneurosci.org/content/18/15/5555
  4. http://www.ncbi.nlm.nih.gov/pubmed/15046869 

    Molecular analysis of nicotinic receptor expression in autism.

  5. Neurotransmitters in autism and role of calcium signalling ... receptors, with
    binding of muscarinic M(1) receptor being up to 30% and that of nicotinic
    receptors being 65%-73% lower in the autistic group compared to controls [
    11431227]. ... release of dopamine and acetylcholine has also been observed [
    www.autismcalciumchannelopathy.com/Neurotransmitters.html -

  6. Nicotine interacts with nicotinic acetylcholine receptors (nAChR) which are ... on
    developmental disorders such as schizophrenia, bipolar and autism ... (2006) "
    Effects of paraformaldehyde fixation on nicotinic acetylcholine receptor binding in ...


  7. Deficiency of Nicotinic Receptor-Neurexin Interactions in Autism ... type of
    receptor called nicotinic acetylcholine receptors has been reported in ... In
    addition, it aims to determine whether the activation of nicotinic receptors by
    drugs that bind ...


    THis is YET another 200,000 GRANT to STUDY something in autism. Good luck with that study....i wonder if we will ever hear the results or if it will ever HELP any autistic person????? No doubt this study will end with "further studies are needed.." 
  8. (nAChRs) and autism,,,,suicidal/self-injurious behaviors, among .....
    NAChRs contribute to the regulation of several mood-related ......Yerkes National Primate Research Center for Behavior Neuroscience, Emory ...
    Nicotinic cholinergic receptor agonist ( nAChR) .... Self Injurious Behavior .....Acute tryptophan (use 5HTP??) depletion and self-injurious behavior in aggressive patients and
    .... the subunit composition of brain nicotinic acetylcholine receptors (nAChRs).

Kim Oakley


Lestat said...

With the history of antipsychotic use, have you considered akathisia as being the cause (or part of)your son's troubles of late? would make sense there being a low dopamine level, if that were the case, might explain why he is so dramatically responsive to nicotine.

The movements of someone experiencing akathisia can show as tremors, or continuous need to move, and inability to sit still. Could potentially be seen as a seizure, if that was what was specifically being looked for visually. I've had both, and akathisia is just about the worst thing ever, seizures suck big time, so does the post-ictal period but I would take any number of them over akathisia.

Its a known side effect of neuroleptics, and in some unfortunate cases can persist after withdrawing the neuroleptic drug (which are not safe in any case, for use in epileptic patients, they lower seizure threshold)

Nicotine doesn't increase acetylcholine levels, it directly stimulates nicotinic acetylcholine receptors, resulting in increased dopamine, serotonin, noradrenaline and opioid peptide release.

If all else has failed, trying a low-dose, long-acting opioid might help. Be aware of potential for lessened gut motility with almost all opioids though.

Piracetam might be useful also, it facilitates uptake of choline in the CNS (I use it myself, and yes, if you were wondering, I'm autie. Its sold as a supplement for memory/cognitive improvement). Should always be taken with choline supplements.

For seeing things from the autie and aspie perspective, aspiesforfreedom.com might be useful, certainly has been for me.


(name is same as username there)

Anonymous said...

Sounds like I'm a bit late on this one, but since I can offer a different perspective that may help others, I will do so.

I am fifty, have high-functioning AS, and am a longtime tobacco user. It is my belief that tobacco/nicotine is the biggest single reason I am able to function so well. I first used tobacco when I was fourteen because I loved what it did for me. It not only improved my concentration, made me more sociable, and even helped stabilize my moods. In fact, as one who has held a demanding job for years, I can say that tobacco is what keeps me functioning; problems aside, it is wonderful stuff for my autism.

Of course, unlike oral and nasal tobacco, cigarettes do take a toll on the health. For this reason, I only use them occasionally, and in very stressful situations; otherwise I use nasal snuff, which seem to have no noticeable health impacts.

I realize that other aspies and autistics may be different, but for me tobacco works, and I speak from my own personal experience.

To the moderator: If you have any further questions, you are more than welcome to contact me at: dunnyveg@gmail.com

Илья Сергеев said...

Thank you very much, Kim and those people who added their comments, for this information! Hope your son is better now and you all too!

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