Category Archives: Interventions

Medication and psychiatric intervention for adult Asperger syndrome

Interventions, Medication

Adults with Asperger syndrome sometimes find themselves in a twilight land between social, medical and disability supports, where the issues of daily living are neither a ’medical problem’ nor a ’disability problem’ — just like ’normal’ people. Many adults with Asperger syndrome have arrived through other diagnoses first, or have current mental health issues (comorbidities). Formal supports tend to assume one primary need, such as disability support if IQ is below a threshold of 70 or mental health services when psychiatric symptoms are deemed clinically significant. The formal supports are not integrated, may prohibit access to more than one service and address social issues through their own re-interpretations. Medication can be very helpful, but can also be used as a substitute for supporting the life issues that are causing difficulty.

TLDR? This is a rant.

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Non-fiction on the autism spectrum

Book, Interventions, Statistics

ASD-non-fictionThis is a brief post to note a collection of short reviews about non-fiction books about autism, relevant mostly to adolescents or adults who have a diagnosis. They include autobiography from Luke Jackson, Temple Grandin and Liane Holliday Willey; historical work from Uta Frith, Adam Feinstein and Steve Silberman; and practical intervention texts from Tony Attwood, Mohammed Ghaziuddin and Florica Stone.

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Social calories and autism

Diet, Interventions, Social communication

I have talked and written about ‘social calories’ to describe the impact that social interaction has on me, usually in terms of trying to limit my intake of social calories. This would often mean a choice between one activity with lots of gentle socialising or another with shorter, intense interaction. Too many social calories make me (physically) sick if I don’t pace myself. In short, Daisy wrote of one social occasion, “a surfeit of ‘social calories’ – the effort of making social contact with so many unfamiliar people in such a short time, and eating unfamiliar food, made me feel sick.” The Enchanted Doors, “A Book to Read When You Have Asperger Syndrome”. You can watch a presentation with visuals — about 13 minutes in, I talk about social calories and social misunderstandings in The Spooky Powers of Normal People).

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Zipit Forest Adventure Trail

Interventions

(Many thanks to Ann Marie for suggesting an activity I would never have thought of for myself)

I am afraid of heights, and especially of edges (acrophobia rather than vertigo), so the idea of voluntarily climbing up a tree and walking the tight-rope before launching my body into the air is terrifying. I have some issues with proprioception and balance that add to the fear. However, thanks to the clear instructions, the quality of the courses and the encouragement of the group (especially Ann Marie), this was an exciting and confidence-boosting day out. It was terrifying and it was tiring, but I went home with an exercise-high that lasted for several days. It also gave me a great sense of achievement and confidence – so much that I intend going back to attempt the higher two levels.

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Psychotropic drugs – guideline and reality

Interventions, Medication

This network map of prescribed medication began with a couple of informal surveys on an autism web forum, where it was rapidly obvious that prescribed medication exceeded any guidelines for the treatment of autism. Remember that medication is not recommended for the core symptoms of autism, because there are no medications that improve core function. There are many medications that assist with symptoms associated with autism – anxiety, depressions, obsession and challenging behaviour.

Below is a graph of psychotropic medication taken from the latest edition of the British National Formulary (68th edition, 2014). Individual medication names as generic name (Brand name) appear down the centre column. To the left are the psychotropic family groups and to the right are the main symptom family groups. E.g. atypical antipsychotic -> aripripazole (Abilify) -> schizophrenia, linked in black. The coloured lines indicate that this treatment path is recommended for challenging behaviour in autism by the US National Institutes for Mental Health (blue), Cochrane Collaboration and Griffith’s pharmacy guide (green).

This image is a discussion topic, not a scientific finding, and feedback is welcome.

Autism-psychtropics

On the non-diagnosis of Professor Don Tillman

Book, Interventions

In The Rosie Project (Graeme Simsion, 2012) we are introduced to Don Tillman, a socially inept professor of genetics who appears to have all the pre-requisite impairments for a diagnosis of Asperger syndrome. However, he is not diagnosed during the course of the book, nor following marriage in the follow-up The Rosie Effect (Graeme Simsion, 2014). The possibility of mental illness is mentioned, although “no definitive diagnosis other than depression was ever recorded” (The Rosie Effect). Somewhere, twenty years in Don Tillman’s past, is a largely irrelevant medical file in which the tentative diagnoses of “‘depression, bipolar disorder? OCD?’ and ‘schizophrenia?’” have been suggested, but the best efforts of 1990s psychiatry failed to fit Don Tillman into any simplistic category (The Rosie Project).

Rosie-project-wordle
The Rosie Project wordle (www.wordle.net)
Rosie-effect-wordle
The Rosie Effect wordle (www.wordle.net)

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The value of labelling autism – Critical Perspectives 2014

Medication, Presentation, Service use

Presentation at the 6th Annual Critical Perspectives Conference, 12 & 13th November 2014, University College Cork. The conference considers and explores:

  • the value and relevance of psychiatric diagnoses in understanding and responding to a wide range of human experiences of emotional distress
  • Critical perspectives on and creative responses beyond psychiatric diagnoses

Audio of the presentation (35 minutes, 11 MB):

PDF handout (6 slides per sheet, 3 sheets in total, 1.8 MB):


Stuart Neilson – The value of labelling (handout)

Online video: http://ucc.hosted.panopto.com/Panopto/Pages/Viewer.aspx?id=b41c413a-d375-4a81-b80c-fbc473b846fd

Diet and ASD

Diet, Interventions

Summary: There has been insufficient research to suggest any diet specific to ASD, but plenty to know that everyone requires a balanced diet and sufficient exercise. Some off-the-shelf supplements may help. One excellent guide is the (unfortunately titled) book “Nutrition for Dummies” by Carol Ann Rinzler and you will find similar books at shelf-mark 613.2 in any local library.

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Medication and autism

Interventions, Medication

In an informal straw poll of the prescription drugs that a group of adults with autism, they reported using Antianxiety medication, Antidepressants (SSRI – venlafaxine / Effexor; SNRI – duloxetine / Cymbalta; tricyclic – amitriptyline), Stimulants (Dextroamphetamine; Ritalin, Concerta / Methylphenidate), Antipsychotics (chlorpromazine / Clonactil) and Mood stabilisers.
They also reported using Beta-blockers (propranolol), Atypical antipsychotics (quetiapine / Seroquel; Abilify / Aripiprazole), pregabalin / Lyrica, progesterone.

Of those who did use prescription drugs, the use was:

Antidepressant drug 25%
Anti-anxiety drug 22%
Antipsychotic drug 2%
A combination of these 27%
Other psycho-active drugs 16%
Other (non-psycho-active) prescription drugs 5%