Shifting the spectrum

I was really happy to read the results of a new study published in the most recent issue of Biological Psychology. Because it involves a group of patients that are very near and dear to my heart–those on the pervasive developmental disorder (PDD/Autism) spectrum.

I am not here to debate the causes of the enormous rise in children with this diagnosis.  We can save that for another day. Today, I have good news. And not just for the victims of autism. But also for their parents. Because it’s truly moving to see how many of them are ready and willing to do whatever it takes to help their child. Even if the progress is in tiny increments, they are always super motivated.

And it’s not easy to be a parent of a child “on the spectrum.” Any intervention that you may want to try that doesn’t involve giving your child psychotropic medications is looked down upon. (In fact, in New York State, it is considered child abuse.)

But there are effective non-drug approaches.

Studies have shown that dietary restrictions have very promising results from eliminating gluten, casein, and yeast from the diets of autistic children.

But the new, small, pilot study I mentioned above is one of the first to look at the potential benefits of supplements for this condition.

The 12-week, double-blind, randomized, placebo-controlled study involved 33 children (ages 3 to 12) with an autistic disorder. Researchers gave the children either N-acetylcyteine (NAC)–a specific antioxidant supplement–or a placebo for 12 weeks.

The NAC treatment increased incrementally over the course of the study. Children in the NAC group got 900 mg daily for 4 weeks. Followed by 900 mg twice daily for another 4 weeks, And, finally, 900 mg 3 times daily for the remainder of the trial.

Compared with placebo, NAC treatment was associated with a significant decrease in irritability, repetitive behaviors, social cognition, and other autism mannerisms. These improvements were clear by week 4 and continued through weeks 8 and 12.

As usual, the lead author, Dr. Hardan had to temper the findings by saying that “The change is not as large as that seen in children taking antipsychotics, but this is still a potentially valuable tool to have before jumping on these big guns.”

I couldn’t agree more. I just wish there were more doctors out there like him. (Or me for that matter!)

Mild gastrointestinal upset was the most commonly reported side effect. Which is an important point, considering the “approved” treatments for these kids have a propensity to cause serious side effects. Such as weight gain, metabolic abnormalities, and tardive dyskinesia–a serious movement disorder that can never be stopped once it sets in.

I used to only recommend NAC to patients who needed extra anti-oxidant support. But you can bet it will be a permanent fixture for my autism patients from here on out.

“A randomized controlled pilot trial of oral N-acetylcysteine in children with autism.” Biol Psychiatry 2012; 71(11): 956-961