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A Longitudinal Investigation of Psychotropic and N...[J Autism Dev Disord. 2009] - PubMed Result

PubMed Investigation, May 2009

 

 

Approval process lowers the number of kids on atypical prescriptions (USA)
By Kris Hundley, Times Staff Writer, St. Petersburg Times
Sunday, March 29, 2009
 

Nudged by public pressure, Florida health officials took a baby step last year toward reining in the use of power­ful antipsychotic drugs among children: They began requiring that doctors get approval before giving these drugs to kids under 6 on the Medicaid program.

That simple step prompted a seismic change in doctors' prescribing habits. The number of prescriptions of these potent drugs to kids in this age group plummeted nearly 75 percent.

Full story and space to comment

 APANA news headlines 2008 | APANA news headlines 2007 
Sabine ad Sandrine Bonnaire's film about her sister, available on DVD. 

"a brilliant documentary feature film about an autistic woman whose spark and vitality and intelligence and will to participate were all demolished by treatment with neuroleptics"

"See this film, you will not regret it!"

Autism Information Library

Autobiography of Anonymous

brain diagram

Crazy adverts for crazy products

Feb 20, A look at some major medication, the ads they use, and the side-effects they have. (link to Bonkers Institute)

APANA: America Approves Antipsychotic Drug for Teens

23 AUG 07: In case you missed this. WSJ report.
Yes, those are Lego blocks (actual Lego blogs, a kid can build w/them), a cookie or candy dispenser (literally, it's a cookie/candy dispenser, according to J&J), and microwave popcorn, all of which advertise Risperdal.

According to Bazire's professionals' pocket handbook 'Psychotropic Drug Directory' 2003-2004 p25:
"...autistic individuals seem very sensitive [to antipsychotics] and so lower doses may be needed. A therapeutic window may exist with higher doses counter-productive."

The Pills in Question: Neuroleptic/antipsychotic medications
Generic name 1st then UK brand name

Benperidol=Anquil: Chlorpromazine=Largactil:*Clozapine=Clozaril: Droperidol=Droleptan: Flupenthixol=Depixol;Fluanxol:Flupenthixol decanoate=Depixol:*Fluspiriline=Redemptin depot: Haloperidol=Serenace, Haldol, Dozic:Haloperidol decanoate=Haldol Decanoate: Loxapine=Loxapac:Methotrimeprazine/Levomepromazine=Nozinan:
*Olanzapine=Zyprexa:*Oxypertine=Oxypertine:Pericyazine=Neulactil:Perphenazine=Fentazin:Pimozide=Orap: Pipothiazine decanoate=Piportil depot: Prochlorperazine=Stemetil: Promazine=Sparine: *Quetiapine=Seroquel: *Remoxipride=Roxiam:*Risperidone=Risperdal: *Sertindole= Serdolect :Sulpiride=Dolmatil, Sulparex, Sulpitil:Thioridazine=Melleril: Trifluoperazine =Stelazine :Zucopenthixol decanoate=Clopixol depot: Zuclopenthixol=Clopixol

*"atypical", more recent, antipsychotics which may not have such severe immediate side effects but many are implicated in heart problems and extreme weight gain.

Some useful references which add up to the conclusion that people on the autistic spectrum are uniquely likely to be inappropriately prescribed harmful antipsychotics (see list of effects below): Autisme- Europe: 1999: European code of good practice for the prevention of Violence and Abuse against People with Autism: Brussels: DAPHNE/Autisme-Europe; Bhaumik S, Branford D, McGrother C, Thorp C: 1997: Autistic traits in adults with learning disabilities: British Journal of Psychiatry:170: 502-506; Branford, D: 1996: A review of antipsychotic drugs prescribed for people with learning disabilities who live in Leicestershire: Journal of Intellectual Disability Research: 40: 4: 358-368). Manchester, D: 1993: Neuroleptics, learning disability, and the community: some history and mystery: British Medical Journal: 307: 17 July: 184-187, Murray,D (1999) Potions Pills and Human Rights, Good Autism Practice vol 1,no1,pp71-84 or go to http://www.autismandcomputing.org.uk/potions.htm for a longer version; Robertson, Emerson et al (in press) Receipt of Psychotropic Medication for People with Intellectual Disabilities in Residential Settings.

Side effects of neuroleptic medications
(compiled from manufacturers' datasheets and elsewhere )
* signifies an effect which may be easily missed in those who do not self-report

Frequent onset effects, sometimes fade with time
Blurred vision*
Breast enlargement, milk flow
Constipation*
Decreased sweating*
Dizziness, low blood pressure*, falls
Drowsiness* Dry mouth*
Headache*
Increased skin-sensitivity to sunlight*
Lightheadedness*
Menstrual irregularity or absence
Sexual difficulty*, decline in libido*, genital pain*

 

 

Other
Catatonic decline
NMS neuroleptic malignant syndrome: a condition marked by muscle stiffness or rigidity, dark urine, fast heartbeat or irregular pulse, increased sweating, high fever, and high or low blood pressure.
Unchecked this condition can prove fatal. Call the doctor immediately if you notice any of these symptoms. NB newer neuroleptics appear just as likely to provoke this syndrome.Torsades de Pointes: a condition which affects the heart rhythm and can lead to sudden cardiac arrest, when it is usually fatal.

Effects which typically remain, worsen or appear with prolonged use
Cataracts*
Difficulty urinating*
Difficulty talking*
Difficulty swallowing*
Eyes turning upwards
Fatigue*
Lassitude/torpor
Tardive dyskinesia (movement disorder)
Tongue edge "snaking"*(early sign of movement disorder)
Jerky movements of head, face, mouth or neck
Muscle spasms of face, neck or back, twisting the neck muscles
Restlessness, physical and mental* resulting in sleep difficulty
Restless legs resulting in inability to sit down
Saliva drooling
Seizure threshold lowered
Skin rashes, itches, discolouration
Sore throat*
Staring looks
Stiffness of arms or legs*
Swelling of feet
Trembling of hands
Uncontrollable chewing movements
Uncontrollable lip movements, puckering of the mouth
Uncontrollable movements of arms and legs
Unusual twisting movements of body
Weight gain
Yellow eyes, skin (indicate liver problem

Frequently found symptoms of abrupt withdrawal from neuroleptics
nausea*   emesis   weight loss   diarrhoea   rhinorrhoea (runny nose)   diaphoresis (heavy sweating)   myalgias (stabbing pains)*   paresthesias (odd sensations, eg burning feelings,etc)*   anxiety*   agitation   restlessness   insomnia   increased tremor    (unmasked by withdrawal)



HAVE YOU GOT A STORY TO TELL?
APPEAL FOR INFORMATION - OPPORTUNITY TO TALK TO A LAWYER


The use of prescribed drugs - especially antipsychotics - drugs to control the "challenging behaviour" of people with learning difficulties or autistic disorders has been of concern for many years. The Government has now officially recognised the problem in its recent White Paper, Valuing People: A New Strategy for Learning Disability for the 21st Century:

Studies of the management of people with challenging behaviour have shown an over-dependence on the use of psychotropic drugs with poor outcomes as a result. (p60)

There are concerns that alternatives are not properly considered before the use of drugs, many of which carry risks of side effects which can cause social exclusion as well as physical harm.

Where the individual mentally incapable of making the decision him/herself, treatment can only be given if it is in his/her best interests*. The "best interests" test is not just a question of whether the treatment is acceptable medical practice. Ethical, moral, social and welfare considerations are also relevant. The availability of a less restrictive or invasive approach - such as addressing communication difficulties which may generate "challenging behaviour" - is of particular importance.

APANA (Autistic People Against Neuroleptic Abuse) is concerned that the rights of people with learning difficulties and autistic disorders should be properly and fully respected in treatment decisions. The group, with the help of their legal advisers, is hoping to take up these issues with the Department of Health. If you or a member of your family has been prescribed psychotropic drugs to control behaviour, or this is currently being proposed, and you are unhappy with the treatment decision or have noticed unwanted side effects, APANA would like to hear from you. All information given would be treated in confidence unless you give your permission for it to be used.

Please contact Karen Ashton through Tyndallwoods Solicitors on [UK] 0121 243 3139.

* If the person is detained under the Mental Health Act 1983, the Act itself permits treatment in the absence of the patient's consent, whether they are incapacitated or not, but only in certain circumstances.


March 2001

Some quotes from UK Government White Paper Valuing People: A New Strategy for Learning Disability for the 21st Century

"Studies of the management of people with challenging behaviour has shown an over-dependence on the use of psychotropic drugs with poor outcomes as a consequence." p67

"Challenging behaviours are best thought of as being a way in which people respond and try to gain control over difficult situations. Psychotropic medication may be very effective when there is an underlying psychiatric disorder but there is concern that too often this medication is used as an alternative to adequate staffing." p110

Chair : David N Andrews : http://www.angelfire.com/in/AspergerArtforms/
Patron : Wendy Lawson : http://www.mugsy.org/wendy
c/o 42 Cheverton Rd London N19 3AZ