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Q: Autism & Bipolar Disorder
Dear Dr. Phelps,
First, thank you for the excellent site and info. My question has to do
with the possible overlap of neurological or neurochemical bases of Bi-polar II
and Autism. Our 10 yr old son is Autistic (onset at 22 months, typical pattern
of tactile defensiveness, sensory integration difficulties, flapping, self-stim,
odd gestures and sounds - although quite verbal). He has shown a slight
improvement with Prozac taken now for 13 mos.
Moreover, both my husband and myself have been diagnosed with Bi-Polar II (mine
more depressive, his more rapid cycle) and in my husband's case Prozac when
combined with Wellbutrin has shown positive results, again not many although he
has been taking this combo for 3 yrs. In my case, 450 mg of Effexor taken
in tandem with Dexadrine also for the past 3 yrs has been virtually no use: 2
attempted suicides, acute depression, chronic insomnia.
Since we all three have biochemical challenges that appear to be similar, could
there not be some overlap between Autism and Bi-Polar in more ways than just in
terms of symptomology? Should I have our son looked at anew from the
perspective of our recent Bi-Polar diagnosis? or ourselves in terms of his
of Autism?
Thanking you for your time and consideration,
Dear Ms/Mr. H' --
Well, when you don't know anything, try Google, right? So, searching
"bipolar autism" to see what's out there.... I found a letter I wrote
on this site a while back, saying I don't know anything -- very useful,
especially since the single link in there is broken now anyway.
But here are a few things that emerged from a new
search on Google, and then the same search terms entered on
Pub
Med (as you can see, the answer is still "I don't know anything about
this"). First, here's an article I'll bet you've found already,
associating autism with the "reelin" gene, suggesting as well that
reelin has been associated with bipolar disorder:
Keller
. There is another report that does indeed associate reelin with bipolar
disorder:
Fatemi
. However, I'm not aware of major news breaking about reelin and bipolar
disorder or autism, since these 1991 publications, so it's not clear how
much value to place on these individual pieces of research (on the other hand,
this is not a rail I've got my ear on most of the time, either).
There is an open trial of Depakote, as you know one of
the most commonly used mood stabilizers, in 14 kids with autism (Hollander)
in which 70% got better -- but no explicit connection drawn, in the abstract at
least, between the two conditions.
That's it for the search this time. I did note
while surfing around that there seemed to be other cases, e.g. one case report
from Brazil, of bipolar disorder and autism showing up in the same kids.
Obviously there was an additional case in the one other
letter
to this site, which you'll find strikingly similar to your circumstance if you
haven't seen it already.
So, there seems to be some sort of connection,
possibly, but again nothing solid about that possible connection --
yet.
Dr. Phelps
Published April, 2003
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