Naltrexone is currently not approved by the United States Food and Drug Administration for the management of symptoms and behaviors associated with autism. This article reviews 22 available studies (published between 1987 and 2001) and finds that naltrexone may help to stop self-injurious behavior as well as hyperactivity, agitation, aggression, irritability, temper tantrums, social withdrawal, attention, eye contact, and stereotyped behaviors.
The authors begin by outlining the theory that children with autism may have high levels of the protein by-products casomorphine and gluteomorphine in their systems. These by-products are created as a result of digesting milk and grain proteins. Naltrexone blocks some of the action of casomorphine and gluteomorphine in the brain. Some of the studies included in this review showed that daily naltrexone treatment (doses ranging from 0.5 to 2 mg/kg/day, or 10-35 mg a day for a 40-pound child) resulted in improved behavior. The authors suggest that most likely only a small percentage of children with autism can be helped by naltrexone, and they acknowledge that it is difficult at this point to identify these children. The authors conclude by suggesting that naltrexone therapy (beginning at 0.5 mg/kg) be tried in children with autism and self-injurious behavior, especially if all other therapies have failed. Finally, the authors note that the most commonly reported side effect of naltrexone was sleepiness.
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Party-time, excellent!
Sep 29, 2008 by AnonymousI think we’ve finally settled on the half Clonidine in the morning as a means to help Thomas settle and focus at school every day. The sleepiness and fatigue have worn off and his teacher reports that he’s doing fine. I forgot to give him his medication on Friday morning, but luckily it was Pajama Party Day, so all the kids were running amok. The teacher said that he was excited, but she chalked that up to the “party atmosphere” – a term that reminds me of my dorm days at college – so she wasn’t concerned about his behavior that day. He was not excited about wearing pajamas to school, but he did it. He was also concerned about the whole party thing, saying that he didn’t want to have a pajama party and that it would be “horrible.” What he’s really saying is that he doesn’t understand what a pajama party entails and that he is, if not afraid of the unknown, ambivalent about it.
When I picked him up after class on Friday, he reported that he had a great time and that the pajama party was “wonderful.” That’s really the word he used to describe it! My children have fabulous vocabularies, a trait that I’m proud they inherited from their mother. As a reward for not pitching a tantrum about the party and both of the kids staying in their own beds on Thursday night, we went to Chuck E. Cheese’s for lunch. It’s so great going on a school day when it’s nice outside because the place was a ghost town. They had fun and when the tokens were gone, they agreed that we should go home.
Jonathan and I had parties all weekend, or at least I did. My sister’s bachelorette party was Saturday night and I stayed over at the maid of honor’s condo. We had a great time, but the kids didn’t want me to go. Jonathan is out of the house all day last Sunday at the Bears game and they didn’t bat an eye about it, but if I take my hair dryer out from under the sink and start blow-drying, they know Mommy’s planning to leave the house and they start putting up a fuss. Jonathan does too, he’s just not as direct about it. Thomas gets upset when I walk the dog for forty minutes every evening, saying, “Don’t go Mommy! I’ll miss you!” Very cute, I guess.
I’m getting so old. At ten-thirty on Saturday night, I was having a hard time keeping my eyes open. The other ladies at the party were sort of the same. We kept looking at our watches and exclaiming, “It’s only eleven? Gee, it feels like 2:30 a.m! Do you have any coffee?” The maid of honor, in her infinite coolness and wisdom, went to the Cheesecake Factory and bought eight different slices of cheesecake which we all passed around and shared. We all sat there, our mouths full of whipped cream and cake, saying, “God, this is way better than any stupid stripper!” We all had fun, especially the bride. The next morning, I got up and went for a jog around my hometown, which was so much fun (except the jogging part). I ran by the houses we grew up in and our friend’s old houses. I was running by the junior high and remembered that the last time I ran down that block, I was probably being timed for a mile. I’m glad I wasn’t being timed this time.
Yesterday afternoon, my cousin Susie came to watch Thomas and Hayley while Jonathan and I attended a retirement party. The kids are so good for babysitters, and especially our family members. The kids know Susie from vacations, and it appears as though Hayley has the same stellar memory that Thomas does. We were telling the kids on Friday that Little Susie (so called because her mom, my aunt’s name is also Susie) would be coming to watch them and Hayley said, “Yeah, remember at the vacation house when she helped us bring food in?” Jonathan and I stared at each other for a moment and then remembered that Little Susie had helped us bring in groceries shortly after we got there. We never would have remembered that. The kids get confused and call her Aunt Susie sometimes, which is total payback because I used to babysit her and her older sister when they were young, and they called me “Aunt Jenny” or sometimes, my favorite: “Cousin-Aunt-Jenny.” Little Susie was also the one who, when she was three, told me that I had a lot of nose-hair. I’m still waiting for Thomas or Hayley to get her back for that one. It’ll happen – I just have to be patient.
So I wasn’t home for most of the weekend. We’re keeping next weekend open just for incidentals and anything I have left to get, buy or help with for Tina’s wedding in less than two weeks. I can’t believe it’s upon us! Rehearsal Dinner Friday, Jonathan is taking the day off work and my mother-in-law is taking the kids all weekend, probably through to Monday since that’s Columbus Day and there’s no school. I talked to my sister Tiffany last night, who will be flying in with her fiancé the Wednesday before the wedding and she has promised to bring candy and gifts for my children. I say load ‘em up on Friday…they’re going with Grandma!
We have a hectic and exciting two weeks to look forward to while also trying to keep things sane and on as much of a schedule as we can. I can’t even think about Halloween costumes or anything like that at least until after the wedding. My brain is aging. I can only take so many marbles rolling around up there at a time.
Sleepy, Dopey and the Doc
Sep 19, 2008 by AnonymousThe saga continues with the medications. I’m sure that the neurologist (with whom I have not spoken in person or over the phone) is tired of me calling the office to give “updates” on Thomas. Since last Friday, the doctor asked us to give Thomas one-half of the Clonidine tablet in the morning and keep him on two at bedtime. Last weekend was the first time we tried it and Thomas was very sleepy in the morning as a result. Not hyper-active either, but rather dopey. Sunday night I sent an e-mail to Thomas’ teacher explaining that if Thomas seemed sluggish in class on Monday, it was not because we replaced the milk in his Lucky Charms with Miller Light. He really does seem kind of drunk when he takes the Clonidine and at night, this is okay. Anyway, Monday morning I chatted with the teacher and she said that Thomas was good, just “different.” Last Thursday and Friday when he took nothing in the way of medications before school, the teacher reported that things were “pretty rough” for Thomas. It’s really too bad about the Focalin. It worked for Thomas except for the facial tic.
We’re going to stick with the half Clonidine in the morning, because after speaking with the neurologist’s office on Wednesday night, she said that the sleepiness should wear off after about a week but the calmness and focus should remain. I’ve actually already noticed that he seems not so sleepy after taking it in the morning. There are other options, apparently, but we know how well Thomas tolerates Clonidine so we’re going to stay with what we’re sure of.
My Internet job search continues. I’m looking for part-time word processing stuff I can do at home in the afternoons. Most places are looking for “cyber assistants,” but that would require answering phone calls. Phone calls are no good because the kids know that when Mommy is on the phone, it’s open season or “Thunderdome” as Jonathan would call it. There are so many scams out there, too! The one thing I qualified for in terms of typing speed and accuracy is only hiring people who have legal document experience. I’m really hoping that if something comes along, the kids will cooperate and let me earn some dough.
Hayley is doing well in preschool and seems to like it. She’s made some friends and her teachers are nice. It’s like pulling teeth to find out what the kids did in school on any given day. Hayley’s got her head in the clouds and is content to sing songs from “The Wizard of Oz” on the way home from school, and if I pepper Thomas with too many questions, he shuts down, saying, “I don’t want to talk about it anymore!” True to his nature, however, he is only too glad to report who wasn’t behaving in class and who got a “yellow.” The teacher uses a green-yellow-red system to report to parents on how their kids did that day. I’ve observed this in class and she actually lets the kids push her pretty far before they have to change their card to yellow. If they clean up their act, she lets them change back to green. There are a couple of kids who are consistently “in yellow” as the day closes. I picked them out right away on the two Tuesdays I’ve been there to help out, even before the teacher had had enough of their tom-foolery.
Thomas has been in green every day, but I think that the teacher is a little more lenient with Thomas’ behavior. I’ve never seen him act up on Tuesdays, but she seems a little gentler with him when she has to remind him about what he’s supposed to be doing. Yeah, it’s probably because I’m in class and she doesn’t want to holler at him while I’m there, but I think she’s probably just a little more understanding because of his problems. I know that if the teacher ever told him to change his card to yellow, he would be extremely upset. He knows how important it is to behave, which is nice.
The kids in kindergarten have earned enough marbles for good behavior to have a party! Next Friday is Pajama Party Day! I was invited to come, but Hayley will have preschool that day so I can’t make it. I told the teacher that I would wear my pajamas all day anyway, in honor of the occasion.