Toward drug treatment for autism

I've talked before about hopeful signs of a treatment for autism. Now some researchers have found a drug that improves communication between nerve cells in mice with a disorder called Phelan-McDermid Syndrome, the symptoms of which they say "fall under the autism spectrum disorder category."

It's not a cure for autism, but it's another hopeful sign.

More bad things you can do to kids: nicotine, TV, and cortisol, oh, my!

This month's Archives of Pediatrics & Adolescent Medicine (a JAMA journal) is devoted to early experience and it's effects later in life, all nicely summarized on Science Daily.

One study looked at prenatal maternal use of cocaine, an opiate, marijuana, alcohol, and nicotine and sleep problems in the kids. Of these, only nicotine caused sleep problems. It's not so much that other drugs are turning out to be less damaging to fetuses than we thought (although there is some of that) as that tobacco is turning out to be worse than we thought.

In another study, mothers with bad enough anxiety to make them be taking selective serotonin uptake inhibitors during pregnancy had 3 year olds with increased withdrawal, anxiety, and depression. Some of it is due to a gene variant.

In another study, too much TV at 29 months of age is associated with all sorts of bad stuff in fourth grade:

"Each additional hour (per day) of television in early childhood corresponded to a

• 7 percent unit decrease in classroom engagement, 
• 6 percent unit decrease in math achievement, 
• 10 percent unit increase in victimization by classmates, 
• 13 percent unit decrease in time spent doing weekend physical activity, 
• 9 percent unit decreases in activities involving physical effort, 
• 9 percent higher scores for consumption of soft drinks and 
• 10 percent higher scores for consumption of snacks, as well as a 
• 5 percent unit increase in BMI."

Another study compared kids who stayed with their parents after CPS became involved with kids who went into foster care. "Children who still lived with their parents had different patterns of cortisol production than those in foster care, with flatter slopes in waking to bedtime values," which has god knows what effects on an adult, but you can't imagine them to be good. On the other hand, it shows foster care works, in this respect.

Another study looked at twin pairs where one weighed 20% more than the other at birth. The bigger twin was more likely to have conduct problems at age 3 or 4. The association was stronger with dizygotic twins than between monozygotic twins. So which thing causes which? Or more likely, what initial condition cascades to produce both of them.

Study finds ... something about fat kids' drug metabolism

This kind of reporting annoys the hell out of me. A study looked at how fat kids and normal kids metabolize caffeine and dextromethorphan (the part of cough medicine you can feel coursing through you, though I did see a study that said it didn't reduce coughs).

They found that obese children metabolized both drugs at different rates than healthy weight children.

But they didn't say if they metabolized them faster or slower! Jesus, woman, tell me the results of the study. Don't just tease me and make me hope some actual news organization will cover the conference and report on it, or pay the subscription fee to the journal.

Meth is worse than coke

A couple of weeks ago, I posted that the in utero effects of cocaine use by pregnant women were not as bad as feared. Now researchers have found the particular brain structures damaged by methamphetamine use, and it looks worse than alcohol by itself, and since most pregnant women who use meth also drink, it makes a real mess.

Poor kids prescribed more antipsychotic drugs

An article in the New York Times says a team of researchers have found that kids on Medicaid (I.e., poor kids) are given antipsychotic medicines 4 times more often than kids on private insurance, and they they get it for less serious conditions.

Obvious questions include why and what is the result? Should we give fewer drugs to poor kids or more drugs to middle class kids? If we're giving too many,  how do we stop?

Some in the article suggest that doctors and poor parents give their kids drugs because it makes them easier to handle and is easier for all concerned, including parents, than therapy or counseling. Or it may be because Medicaid pays less for therapy than private insurance does, so Medicaid doctors give poor kids what they can afford on their Medicaid allowance, which is drugs rather than therapy. Or maybe poor kids are sicker than middle-class kids; maybe the buildup of cortisol stress of living in poverty causes more mental illness. One person in the Times article suggested this might be part but not all of it. If it is true, we have a public health issue we need to deal with.

And it is not at all clear that psychotherapy is better than drugs at controlling mental illnesses. The big disadvantage of  drugs is that if they are prescribed for conditions that they don't have, the drugs can cause much more serious problems than therapy is likely to if therapy is tried on a condition the kid doesn't have. For example, there is some concern lately that bipolar disorder is being diagnosed in kids who don't have it. Therapy is less likely to screw up such a kid's life permanently than drugs, partly because it's less effective.

So it's not  obvious on the surface how big a problem this is, but there is enough of a chance that it's a big one that we need to look further into it.

Another way to mess up a fetus: take the wrong antibiotics

What a difference in headlines.

• In the LA Times, it's "Most antibiotics appear safe during pregnancy, study finds". 
• As the AP sent  it out, it was headed "Study ties common antibiotics with birth defects".
• Science Daily said, "Antibiotic Use During Pregnancy And Birth Defects: Study Examines Associations"

The study said that a number of common antibiotics are safe, most especially the most common, penicillin, but sulfa drugs and nitrofurantoins might cause some bad birth defects.