Meds for autism?

There are medications that help some conditions.   My concentration improves with morning coffee. Those with anxiety have less of it with Valium. No one needs to take those meds – it’s up to the individual. I’m going to write about meds for autism because there are two recent articles with something to say about that.

Before I start, I want to be clear – “autism” isn’t a disease and it isn’t one thing. The label is never the person. And having the same label often doesn’t mean much – like being labeled a baseball fanatic doesn’t predict your intellect or your job or whether you have a good memory or can dance. And medications don’t have to be taken all the time – some may be just for “once in a while.”

With that out of the way, consider an article in Proceedings of the National Academy of Sciences this month with the imposing title, “Plasma oxytocin concentrations and OXTR polymorphisms predict social impairments in children with and without autism spectrum disorder.” Oxytocin has been called a bonding hormone, a social hormone and a love hormone. Interestingly, the authors found that kids with autism and their siblings without autism had similar oxytocin levels – the correlation was 85%. There are also two types of oxytocin receptor in the brain, and one type is associated with folks who are more social. That receptor was also shared equally between the kids with an autism label and their siblings. The siblings were less social but didn’t get a label according to the DSM-IV criteria.

What this hints at is that anyone can be made a bit more social with some oxytocin (there is a nasal spray). Will this be used (will this be useful?) as part of early intervention programs which focus on learning typical social behaviors?  It’s a thought. The road from “maybe” to new drug approval is long, but there may be some clinical trials before long.

The other article is more esoteric. It has to do with mice, which aren’t people, and a mutation in a protein called neurexin. Since experiments like this couldn’t possibly be done in humans, we have to deal with animal models of autism. In this case, mice which aren’t as social, don’t groom, and have repetitive behaviors – that’s the result of this one particular mutation. Not only are mice not humans, but the mutation they’re talking about hasn’t been shown to be a cause of human autism. It does interact with other proteins at brain synapses, however. The interesting thing here is that by turning off the mutant gene, the mice returned to normal. The whole point is this: there’s a switch that can be flipped one way or the other. One way seems like autism. Flip the switch, and pretty soon the mice appear normal. This raises the possibility that some human mutations could similarly cause expression of abnormal proteins that could cause neurological problems which might then be reversed by some medication. That’s a mile down the road yet, but it’s a road that will be explored. This was published in the July 24th issue of Cell Reports.

For those interested, I’m going to post a news clipping about the Oxytocin study, “’Love Hormone’ Oxytocin May Play Key Role in Kids’ Social Skills” plus the original article Abstract on Library Corner.

-Jim Diamond, M.D.