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The Medical Treatment of Autistic People

Problems and Side Effects

  • Chapter
Neurobiological Issues in Autism

Part of the book series: Current Issues in Autism ((CIAM))

Abstract

The proper study of risks attendant on a particular medical treatment, or on a class of treatments, can only be made if proper deference is paid to the potential benefits that may reasonably be expected to accrue. In considering the risks and side effects of medical treatments that are brought to bear in the management of autistic persons, therefore, there is a fatal irony since little direct benefit is known to derive from any somatic treatment. There is no rational chemotherapy for autism. There is no medical intervention that can reverse or undo the physiological basis of the disorder. Indeed, the disorder is not known to be characterized by any specific pathophysiologic defect. From the biologist’s perspective, autism is an impossible concept, one that embraces a wide range of individual deficits and individual patients who differ widely in clinical presentation (Wing, 1969), developmental level, etiology, associated disorders, and prognosis. A generation of research has failed to uncover any single biological mechanism by dint of which such diversity might be reconciled. In the face of such ambiguity, the hope for a specific biological “treatment” is vain.

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References

  • Alhadeff, L., Gualtieri, C.T., & Lipton, M. (1984). Toxic effects of water-soluble vitamins. Nutrition Reviews, 42(2), 33–40.

    Article  PubMed  CAS  Google Scholar 

  • American Pharmaceutical Association. (1979). Handbook of non prescription drugs (6th ed.). Washington, DC: Author.

    Google Scholar 

  • APA Task Force on Vitamin Therapy in Psychiatry. (1973). Megavitamin and orthomolecular therapy in psychiatry. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Campbell, G. D., Steinberg, M. H., & Beven, J. D. (1975). Ascorbic acid induced hemolysis in G6PD deficiency. Annual of Internal Medicine, 82, 810.

    Article  Google Scholar 

  • Campbell, M., Anderson, L. T., Cohen, I. L., Perry, R., Small, A. M., Green, W.H., Anderson, L. & McCandless, W. H. (1982). Haloperidol in autistic children: Effects on learning, behavior, and abnormal involuntary movements. Psychopharmacology Bulletin, 18, 110–112.

    Google Scholar 

  • Campbell, M., Anderson, L., Meier, M., Cohen, I., Small, A., Samit, C., & Sachan, E. (1978). A comparison of haloperidol and behavior therapy and their interaction in autistic children. Journal of the American Academy of Child Psychiatry, 12, 55–67.

    Google Scholar 

  • Campbell, M., Grega, D. M., Green, W. H., & Bennett, W. G. (1983). Neuroleptic-induced dyskinesias in children. Clinical Neuropharmacology, 6, 207–222.

    Article  PubMed  CAS  Google Scholar 

  • Campbell, M., Perry, R., Bennett, W. G., Small, A. M., Green, W. H., Grega, D., Schwartz, V., & Anderson, L. (1984). Long-term therapeutic efficacy and drug-related abnormal movements: A prospective study of haloperidol in autistic children. Psychopharmacology Bulletin, 19, 80–83.

    Google Scholar 

  • Chouinard, G., & Jones, B. D. (1980). Neuroleptic-induced supersensitivity psychosis: Clinical and pharmacologic characteristics. American Journal of Psychiatry, 137, 16–21.

    PubMed  CAS  Google Scholar 

  • Ciaranello, R. D. (1982). Hyperserotoninemia and early infantile autism. New England Journal of Medicine, 307, 181–183.

    Article  PubMed  CAS  Google Scholar 

  • Committee on Dietary Allowances. (1980). Food and Nutrition Board: Recommended dietary allowance (9th ed.). Washington, DC: National Academy of Science.

    Google Scholar 

  • Cook, J., & Monsen, E. (1977). Vitamin C., the common cold and iron absorption. American Journal of Clinical Nutrition, 30, 235–241.

    PubMed  CAS  Google Scholar 

  • Coronary Drug Project Research Group, The. (1975). Clofibrate and niacin in coronary heart disease. Journal of the American Medical Association, 231, 360–381.

    Article  Google Scholar 

  • Davis, K. L., & Rosenberg, G. S. (1979). Is there a limbic system equivalent of tardive dyskinesia? Biological Psychiatry, 14, 699–703.

    PubMed  CAS  Google Scholar 

  • DiPalma, J. R., & Ritchie, D. M. (1977). Vitamin toxicity. Annual Review of Pharmacological Toxicity, 17, 133.

    Article  CAS  Google Scholar 

  • Douglas, J. G., Munro, J. F., Kitchin, A. H., Muir, A. L., & Proudfoot, A. T. (1981). Pulmonary hypertension and fenfluramine. British Medical Journal, 283, 881–883.

    Article  PubMed  CAS  Google Scholar 

  • Engelhardt, D.M., Polizos, P., & Waizer, J. (1975). CNS consequences of psychotropic drug withdrawal in autistic children: A follow-up report. Psychopharmacology Bulletin, 11 (1), 6–7.

    PubMed  CAS  Google Scholar 

  • Evans, R. W., & Gualtieri, C.T. (1985). Carbamazepin: A neuropsychological and psychiatric profile. Clinical Neuropharmacology, 83, 221–241.

    Article  Google Scholar 

  • Feetam, C., Leach, R., & Meynell, M. (1975). Lack of clinically important interactions between Warfarin and ascorbic acid. Toxicology and Applied Pharmacology, 31, 522–527.

    Article  Google Scholar 

  • Fersdyke, D. R. (1976). Ascorbic acid effects on erythrolytes. Annual of Internal Medicine, 84, 490.

    Article  Google Scholar 

  • Finstein, N., Balsen, A., Galper, J., & Wolfe, H. (1975). Jaundice due to nicotinic acid therapy. American Journal of Digestive Disease, 20, 282–286.

    Article  Google Scholar 

  • Fish, B., Campbell, M., Shapiro, T., & Floyd, A. (1969). Comparison of trifluperidol, trifluoperazine, and chlorpromazine in preschool schizophrenic children. Current Therapeutic Research, 11, 589–595.

    PubMed  CAS  Google Scholar 

  • Geller, E., Ritvo, E. R., Freeman, B. J., & Yuwiler, A. (1982). Preliminary observations on the effect of fenfluramine on blood serotonin and symptoms in three autistic children. New England Journal of Medicine, 307, 165–169.

    Article  PubMed  CAS  Google Scholar 

  • Gilman, A. G., Goodman, L. S., & Gilman, A. (1980). The pharmacologic basis of therapeutics: Toronto: MacMillan.

    Google Scholar 

  • Griffith, J. D. (1977). Structure-activity relationships of several amphetamine drugs in man. In E. H. Ellinwood & M. M. Kilbey (Eds.), Cocaine and other stimulants: New York: Plenum Press.

    Google Scholar 

  • Gualtieri, C. T. (1986). Fenfluramine and autism: A careful reappraisal is in order. Journal of Pediatrics, 108, 417–419.

    Article  PubMed  CAS  Google Scholar 

  • Gualtieri, C. T., Barnhill, J., McGimsey, J., & Schell, D. (1980). Tardive dyskinesia and other movement disorders in children treated with psychotropic drugs. Journal of the American Academy of Child Psychiatry, 19, 491–510.

    Article  PubMed  CAS  Google Scholar 

  • Gualtieri, C. T., & Evans, R. W. (1984). Carbamazepine-induced tics. Developmental Medicine and Child Neurology, 26, 546–548.

    Article  PubMed  CAS  Google Scholar 

  • Gualtieri, C. T., Golden, R. N., & Fahs, J. J. (1983). New developments in pediatric psychopharmacology. Developmental and Behavioral Pediatrics, 4, 202–209.

    Article  CAS  Google Scholar 

  • Gualtieri, C. T., & Guimond, M. (1981). Tardive dyskinesia and the behavioral consequences of chronic neuroleptic treatment. Developmental Medicine and Child Neurology, 23, 255–259.

    Article  PubMed  CAS  Google Scholar 

  • Gualtieri, C. T., Quade, D., Hicks, R. E., Mayo, J. P., & Schroeder, S. R. (1984). Tardive dyskinesia and other clinical consequences of neuroleptic tratment in children and adolescents. American Journal of Psychiatry, 141, 20–23.

    PubMed  CAS  Google Scholar 

  • Gualtieri, C. T., Quade, D., Schroeder, S. R., & Hicks, R. E. (1986). Tardive dyskinesia in mentally retarded young adults. Archives of General Psychiatry, 43, 335–340.

    Article  PubMed  CAS  Google Scholar 

  • Harrell, R. F., Capp, R. H., Davis, D. R., Peerless, J., & Ravitz, L. R. (1981). Can nutritional supplements help mentally retarded children? An exploratory study. Proceedings of the National Academy of Sciences, USA, 78, 574–578.

    Article  CAS  Google Scholar 

  • Harvey, J. A., & McMaster, S. E. (1977). Fenfluramine: Cumulative neurotoxicity after chronic treatment with low dosages in the rat. Communications in Psychopharmacology, 1, 3–17.

    PubMed  CAS  Google Scholar 

  • Herbert, V., & Jacob, E. (1974). Destruction of vitamin B12 by ascorbic acid. Journal of the American Medical Association, 230, 41–241.

    Article  Google Scholar 

  • Hines, S. (1975). Ascorbic acid and vitamin B12 deficiency. Journal of the American Medical Association, 234, 24.

    Article  PubMed  CAS  Google Scholar 

  • Ho, H. H., Lockitch, G., Eaves, L., & Jacobson, B. (1986). Blood serotonin concentrations and fenfluramine therapy in autistic children. Journal of Pediatrics, 108, 465–469.

    Article  PubMed  CAS  Google Scholar 

  • Kane, J. M., Woerner, M., Weinhold, P., Wegner, J., & Kinon, B. (1984). Incidence of tardive dyskinesia: Five year data from a prospective study. Psychopharmacology Bulletin, 20(1), 39–40.

    PubMed  CAS  Google Scholar 

  • Lesser, M. (1980). Nutrition and vitamin therapy. New York: Grove Press.

    Google Scholar 

  • Leue, J., & Bachy, R. (1976). Vitamins, their use and abuse. New York: Liveright.

    Google Scholar 

  • Leventhal, B. L. (1985, May 2). Fenfluamine administration to autistic children: Effects on behavior and biogenic amines. Paper presented at the NCDEU Annual Meeting, Key Biscayne.

    Google Scholar 

  • Mosher, L. (1970). Nicotinic acid side effects and toxicity; a review. American Journal of Psychiatry, 126, 1290–1296.

    PubMed  CAS  Google Scholar 

  • Mills, C. (1941). Thiamine overdose and toxicity. Journal of the American Medical Association, 116, 2101.

    Article  Google Scholar 

  • Paulson, G. W., Rizvi, C. A., & Crane, G. E. (1975). Tardive dyskinesia as a possible sequel of long-term therapy with phenothiazines. Clinical Pediatrics, 14, 953–955.

    Article  PubMed  CAS  Google Scholar 

  • Pfeiffer, C. (1975). Mental and elemental nutrients. New Canaan, CT: Keats.

    Google Scholar 

  • Polizos, P., & Engelhardt, D. (1978). Dyskinetic phenomena in children treated with psychotropic medications. Psychopharmacology Bulletin, 14(4), 65–68.

    PubMed  CAS  Google Scholar 

  • Polizos, P., & Engelhardt, D. M. (1980). Dyskinetic and neurological complications in children treated with psychotropic medication. In W. E. Fann, R. E. Smith, J. M. Davis, & E. F. Domino (Eds.), Tardive dyskinesia. Research and treatment (pp. 193–199). Jamaica, NY: Spectrum.

    Chapter  Google Scholar 

  • Richens, A. (1971). Toxicology of folic acid. Lancet, 1, 912.

    Article  PubMed  CAS  Google Scholar 

  • Rimland, B. (1977). Comparative effects of treatment on child’s behavior (Vol. x). San Diego: Institute for Child Behavior Research.

    Google Scholar 

  • Ritvo, E. R. (1985, May). The efficacy and safety of fenfluramine in autism: A multicenter trial. Paper presented at the NCDEU Annual Meeting, Key Biscayne.

    Google Scholar 

  • Ritvo, E. R., Freeman, B. J., Yuwiler, A., Geller, E., Yokota, A., Schroth, P., & Novak, P. (1984). Study of fenfluramine in outpatients with the syndrome of autism. Journal of Pediatrics, 105, 823–828.

    Article  PubMed  CAS  Google Scholar 

  • Rivinius, T. M. (1982). Psychiatric effects of the anticonvulsant regimens. Journal of Clinical Psychopharmacology, 2, 165–192.

    Google Scholar 

  • Rubenstein, E., & Federman, D. D. (1981). Scientific American Medicine. New York: Scientific American.

    Google Scholar 

  • Schaumberg, H., Kaplan, J., Windebank, A., Vick, N., Rasmus, S., Pleasure, D., & Brown, M. (1983). Sensory neuropathy from pyridoxine abuse: A new megavitamin syndrome. New England Journal of Medicine, 309, 445–454.

    Article  Google Scholar 

  • Schrauzer, G. N., & Rhead, W. J. (1971). Risks of long term ascorbic acid overdosage. Nutrition Review, 29, 262–263.

    Google Scholar 

  • Schuster, C. R., & Seiden, L. S. (1985, May 2). Assessment of neurotoxicity of fenfluramine. Paper presented at the NCDEU Annual Meeting, Key Biscayne.

    Google Scholar 

  • Sebrell, W. J., Jr., & Harris, R. S. (1968). The vitamins (2nd ed., Vol. 2). London/New York: Academic Press.

    Google Scholar 

  • Slater, S., de la Vega, C. E., Skyler, J., & Murphy, D. L. (1976). Plasma prolactin stimulation by fenfluramine and amphetamine. Psychopharmacology Bulletin, 72(4), 26.

    Google Scholar 

  • Smith, W. L., & Lowery, J. B. (1972). The effects of diphenylhydantoin on cognitive functions in man. In W. L. Smith (Ed.), Drugs, development and cerebral function (pp. 344–351). Springfield, IL: Charles C Thomas.

    Google Scholar 

  • Stein, H., Hasan, A., & Fox, L. (1976). Ascorbic acid induced uricosuria. Annual of Internal Medicine, 84, 385–388.

    Article  CAS  Google Scholar 

  • Stockley, I. (1981). Drug interactions. London: Blackwell Scientific.

    Google Scholar 

  • Stores, G., Hart, J., & Piran, N. (1978). Inattentiveness in school children with epilepsy. Epilepsia, 19 169–175.

    Article  PubMed  CAS  Google Scholar 

  • Volkmar, F. R., Paul, R., Cohen, D. J., & Shaywitz, B. A. (1983). Irritability in autistic children treated with fenfluramine. New England Journal of Medicine, 309, 187.

    PubMed  CAS  Google Scholar 

  • Von Muhlendahl, K. E., & Krienke, E. G. (1979). Fenfluramine poisoning. Clinical Toxicology, 14, 96–106.

    Google Scholar 

  • Wentzler, R. (1979). The vitamin book: New York: Doubleday.

    Google Scholar 

  • Willett, W., Sampson, C., Bain, B., Rosner, C. H., Hennekins, J., Witschie, J., & Speizer, F. E. (1981). Vitamin supplement use among registered nurses. Annual Journal of Clinical Nutrition, 34, 1121–1125.

    CAS  Google Scholar 

  • Williams, R. J., & Kalita, D. K. (1977). A physicians handbook of orthomolecular medicine. New Canaan, CT: Keats.

    Google Scholar 

  • Winsberg, B., & Yepes, L. E. (1978). Antipsychotics. In J. S. Werry (Ed.), Pediatric psychopharmacology (pp. 234–273). New York: Brunner/Mazel.

    Google Scholar 

  • Wing, L. (1969). The handicaps of autistic children: A comparative study. Journal of Child Psychology and Psychiatry, 10, 1–40.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, 27514, USA

    Thomas Gualtieri

  2. Biological Sciences Research Center, University of North Carolina, Chapel Hill, North Carolina, 27514, USA

    Randall W. Evans & Debra R. Patterson

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  1. Thomas Gualtieri
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  2. Randall W. Evans
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  3. Debra R. Patterson
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Editors and Affiliations

  1. University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA

    Eric Schopler  & Gary B. Mesibov  & 

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Gualtieri, T., Evans, R.W., Patterson, D.R. (1987). The Medical Treatment of Autistic People. In: Schopler, E., Mesibov, G.B. (eds) Neurobiological Issues in Autism. Current Issues in Autism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1992-2_20

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  • DOI: https://doi.org/10.1007/978-1-4899-1992-2_20

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  • Print ISBN: 978-1-4899-1994-6

  • Online ISBN: 978-1-4899-1992-2

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