Autism's drug problem - <AUTHOR> https://spectrumnews.org/features/deep-dive/autisms-drug-problem/ <comment><USER2> Former neuroscientist here. The fundamental problem of psychiatric medications is that the brain is wildly complex and the drugs are very broad-spectrum, activating multiple receptors, including ones you don't want. If you're _lucky_ , a medication is both effective and not too onerous in its side effects.

It's like trying to fix a bad logic gate in your CPU with a soldering iron.

Unfortunately, brain science is still in its infancy, and it may be decades more before we have good drugs for mental illnesses (assuming they can be treated by drugs at all, which may be impossible for certain diseases/people.)

<comment><USER3> Honest question - do you think dietary fiddling around with different intakes / vitamins / fibers / sugars might also be worthwhile avenues to test on a case-by-case basis? I mean, I ask simply because I've seen a couple anecdotal tales of behavior changes (just a difference, not all Pro/Con) by eliminating cow milk. Switching that out changed, well, something and it seemed to have significant effects.

Considering I agree with you that drugs / compounds are like hammering a sewing needle into a pillow, I wonder about diet (+ exercise?) that could be started with cheaper and lower risk.

<comment><USER4> Gastrointestinal issues are common is ASD, and can aggravate ASD symptomatology. This is a hot topic of research.

</comment></comment></comment><comment><USER5> I read advice message boards from time to time, and there are so very, very many people asking questions that include 4 or 5 different psychiatric drugs that they're taking, for a litany of different trendy diagnoses and how they keep changing the doses and adding more and more to counteract side-effects, and it's like -- have you ever just considered, like, 'therapy'? People have been sold this bullshit that if you're not happy all the time, if you're not productive all the time, that you're somehow sick or suffering some sort of deficiency. Sometimes in life you have to be sad, or bored, or distracted. It's part of what makes life worth living.

Everytime I hear the ad for that medicine to counteract opioid-induced constipation, it makes me want to burn down the entire medical industry in this country. We're medicating ourselves to death.

I can't find a link to it now, but I read an article a while back where they did a random study of elderly people taking multiple prescribed medications, having some of them just stop taking all medicines-- and on average their medical condition _improved_. Even people that were taking heart medication, or things like that.

<comment><USER6> Remember though that every condition is different, and it sounds like you're looking at drugs for people on the spectrum to solve these things: " sad, or bored, or distracted"

So i'm not going to focus on these - but give just something else to the topic.

But for many it's not just about these. Drugs can help relieve sensory issues for example, where heightened senses can cause literally physical pain.

I'm not pro drugs btw - as someone with a mother/brother and countless other family members on the spectrum, has worked with kids on the spectrum, goes to talks and conferences on this - therapy and acceptance are the goals I strive for.

But unfortunately - THERAPIES AVAILABLE ARE REALLY SHIT. Really. Really shit and not autism specific. They can cause far more damage than help because they attempt to "normalise" a person(make them appear to be normal to be "cured") and in the long term this has serious repercussions.

</comment></comment><comment><USER7> _Connor was diagnosed with autism early — when he was just 18 months old. His condition was already obvious by then. "He was lining things up, switching lights on and off, on and off," says his mother, Melissa. He was bright, but he didn't speak much until age 3, and he was easily frustrated. Once he started school, he couldn't sit still in class, called out answers without raising his hand and got visibly upset when he couldn't master a math concept or a handwriting task quickly enough._

So far it sounds like textbook bright kid with ADHD to me.

Edit: reading further it seems thats what they originally though too. I have yet to see anything in the description of the first kid that suggests autism. Then again I am no specialist.

<comment><USER8> > I have yet to see anything in the description of the first kid that suggests > autism.

"He was lining things up, switching lights on and off"

That's Autism right there.

There are other things you can test for, but that right there is a big tell for me. You aren't a specialist, and I can't imagine you are around autistic children much if this doesn't jump right out at you.

<comment><USER9> Don't all kids like to line things up and play with light switches? Like, I'm pretty sure every child I've had contact with did stuff like this often enough.

Maybe there's a difference that you can see in person, like body language and such, but from the text description there, it sounds like perfectly normal play for a toddler.

Edit to add: I have limited experience with children on the spectrum, but I have 8 younger siblings spanning 25 years that I've watched grow up and helped raise. Unless they are all on the spectrum, I'm a bit at a loss.

<comment><USER7> My thoughts as well although I wish my kids were a little bit more interested in lining things up.

Mine has so far tended to pile things up and tell me they were "decorating". :-)

Before I start thinking about the autism spectrum I need to see serious communication problems, lack of empathy etc but then again I am no specialist.

<comment><USER10> It seems a little weak to me too. But I think it's one of those things about degree of behavior. My kids would enjoy flipping lights on and off at that age too, but only for a few minutes, or with breaks every now and then. I've had some limited exposure to kids with autism, and I've seen them happy to do things like this for hours at a time. Since it was specifically called out in the article I'm assuming it trended toward longer periods.

That being said it's a generalization and like (basically) everything having to do with autism, generalizations only apply to a very limited set of the population, and can be difficult to distinguish from stereotypes.

Also, obligatory, #IAmNotADiagnostician

</comment></comment></comment></comment></comment><comment><USER11> England has a thing called "STOMP" to reduce polypharmacy and over medication of people with learning disability.

[https://www.england.nhs.uk/wp- content/uploads/2016/06/stoppi...](https://www.england.nhs.uk/wp- content/uploads/2016/06/stopping-over-medication.pdf)

[https://www.england.nhs.uk/2015/07/urgent- pledge/](https://www.england.nhs.uk/2015/07/urgent-pledge/)

[https://www.rcpsych.ac.uk/pdf/2016%20QNLD%20Annual%20Forum_S...](https://www.rcpsych.ac.uk/pdf/2016%20QNLD%20Annual%20Forum_STOMPLD_David%20Branford.pdf)

This kind of thing has a lot of support with NHS and LA care providers; from service users and their relatives, and from carers.

> "Is heavy drug use bad? That's the question. We don't know; it hasn't been > studied."

We do know: Yes, it's bad. It's bad because of all the side effects. It's bad because there's risks with most meds, and you need to balance the risks against the rewards, and if there are no clear rewards it's unethical to subject someone to those risks just in case the med works. Especially so when these are children, some of whom will have lack of capacity because of learning disability, who are not making the decisions.

</comment><comment><USER12> This article makes me really sad. I wonder if they took one sample of blood, stool, hair or spit to see if there were any biomedical anomalies to treat. My nephew's onset of "Autism" (I use quotes because the diagnostic methodology for Autism is casual observation, followed by "I said so" by a doctor) was at about 24 months. His parents refused to accept the prognosis of long term care. They instead found a licensed MD who would take specimens from my nephew and treat any observed deviations from established norms with standard interventions. So what they found over the course of about 4-5 years was my nephew suffered from a massive yeast infection, pinholes in his intestines, heavy metal poisoning, and numerous food allergies. This is an incomplete list, but for every other anomaly they discovered in his blood, stool, etc. they treated it as any trained MD would, if they were looking.

My nephew was diagnosed as "indistinguishable from his peers" at around age 8. Aside from having to eat a rotating diet to avoid the development of new food allergies, he's a normal kid now. He has friends, talks normally, is running track and field for his sport. The only thing that seems a little off with him, he loves good strong bear hugs, and I'm always happy to oblige.

You can dismiss this account as anecdotal and I'm sure many will. What I can tell you, through community connections, we know hundreds of other families who have helped their children recover to varying degrees from Autism. It's not some secret cult of medicine either, it's just a new field of study. The NIH sought my nephew for study, along with hundreds of other children who have recovered from Autism.

<comment><USER13> > heavy metal poisoning

Actually I'm tempted to dismiss your account as complete quackery. Heavy metal poisoning is a common bugbear of quacks. What metal, and where did it come from?

<comment><USER12> Mercury and aluminum. Source unknown. His hair samples revealed no Mercury whatsoever which means his body was doing nothing to metabolize and excrete it. A normal person will show some level of Mercury in their hair as we all have some exposure from environmental sources. This is thought by his doctor to be due to his poor ability to produce glutathione, which comes as a result of a genetic mutation, which was confirmed via genome sequencing.

I don't care about the source of either, just that the tests ordered by the MD revealed their presence and employed chelation to remove them to normal levels.

<comment><USER14> Doesn't it raise an eyebrow that this one kid had such a litany of rare diagnoses? Maybe one or two of those things, but all of them?

I can't help wondering if the true diagnosis here should have been Munchausen syndrome by proxy (on the part of the parents) plus opportunism (on the part of the doctor).

<comment><USER12> As I mentioned above, our family has come to know hundreds of other families that have children experiencing some, all, or more of similar symptoms, and have achieved recovery using similar protocols.

</comment></comment></comment></comment></comment><comment><USER15> Considering autism's fundamental causes are unknown, it shouldn't be surprising drugs made to combat it don't work. Why should they? It sounds like blind experimentation combined with a bit of placebo effect.

<comment><USER16> The Atlantic actually ran an interesting article recently about how autism is also unusually susceptible to the placebo effect, as far as disorders/diseases go* - that certainly doesn't help matters.

* [https://www.theatlantic.com/health/archive/2016/12/spectrum-...](https://www.theatlantic.com/health/archive/2016/12/spectrum-autism-placebo/509189)

</comment></comment><comment><USER17> This is a very important article, I wish I could upvote it more. The dangers of taking such psychoactive substances regularly, in combination, at such a young age with a developing brain, are not to be underestimated!

Parents need to be better informed. They make these decisions for their children when really, a few decades ago, an iron rule was that medicating mental health problems in children is to be avoided if at all possible.

<comment> wu-ikkyu >a few decades ago, an iron rule was that medicating mental health problems in children is to be avoided if at all possible

Perhaps it is because Big Pharma wasn't the beast it was now. Treatment for mental illness decades ago was still quite horrid though -- cutting up "patients'" brains (lobotomy) and electrocution being some of the methods used for "treatment".

<comment><USER11> ECT is still used and it's an important, life-saving, treatment. It's rightly used as a measure of last resort, and there are extra controls to make it much harder to give someone ECT against their will (in England).

If it's being misused in the US that's a problem with the fucking awful state of healthcare over there, not with the treatment itself.

[https://www.theguardian.com/society/2017/apr/17/licking-a- ba...](https://www.theguardian.com/society/2017/apr/17/licking-a-battery-what- its-like-to-have-ect-electroconvulsive-therapy?CMP=share_btn_tw)

[https://www.theguardian.com/society/2017/apr/17/what-is- ect-...](https://www.theguardian.com/society/2017/apr/17/what-is-ect-and-how- does-it-work?CMP=share_btn_tw)

<comment><USER18> Placebo effect.

<comment><USER19> I doubt the physical changes caused by electrodes on your brain are imagined.

<comment> wu-ikkyu Placebos can have biological effects

</comment></comment></comment></comment></comment></comment><comment> wu-ikkyu >>"This is an experiment that's going on, but it's a completely uncontrolled experiment."

All psychiatric drugging is a hypothetical experiment because psychiatric diagnoses are based on subjective social observations rather than biological pathology[1]. However the psychiatric/pharmaceutical establishment still assumes biological causes even though they have no real proof. The mind is a metaphysical concept which no one understands, and yet many stand to profit on this fact by making popular but unsubstantiated assumptions.

Mixing multiple psychiatric drugs further compounds the issue, because when the companies selling these drugs are conducting their trials, they don't do so in conjunction with the myriad of other drugs that are usually prescribed to those with mental illnesses.

[1][https://en.wikipedia.org/wiki/Autism#Diagnosis](https://en.wikipedia.org/wiki/Autism#Diagnosis)

See also:

[https://en.wikipedia.org/wiki/Autism_rights_movement](https://en.wikipedia.org/wiki/Autism_rights_movement)

<comment><USER17> >However the psychiatric/pharmaceutical establishment still assumes biological causes even though they have no real proof.

Yes. I always hear "Chemical imbalance" thrown around but nobody can say which chemicals and how to detect it physiologically and how the medication counteracts it.

<comment><USER11> You don't hear that from psychiatric doctors about SSRIs because they all know it's bollocks.

In England I've only ever met 3 doctors who said mental illness was purely, or even mostly, biological. All the others, including the ones who focused on the diseases we think are biological (bipolar; psychosis) placed great importance on the psychological and social impacts.

</comment></comment></comment><comment><USER16> This article kind of resonates with me, since I was briefly prescribed Adderall in high school. It was more an effort to strongarm me into paying attention than it was to treat a medical condition. And this sounds very familiar:

>But when the Adderall wore off each day, Connor had a tougher time than ever. He spent afternoons crying and refusing to do much of anything. The stimulant made it difficult for him to fall asleep at night.

The thing about Adderall is, it's a close cousin to crystal meth and has some serious side effects. When it wears off, there is a serious come-down, both emotionally and physically, so if you're taking it to focus in school, you're going to be a lethargic and miserable wreck by 4:00 or so.

To me, this is insane and enormously harmful. How could any parent see this, decide that the ends justify the means, and then double down with more drugs to deal with the side effects is completely beyond me.

<comment><USER20> > When it wears off, ... you're going to be a lethargic and miserable wreck by > 4:00 or so.

This is the case for some people, but it's not for everybody who uses these meds, not even close. A lot of people have minimal 'come-down' effects, if any at all.

As others have posted here, our brains are poorly understood, enormously complex and act and react in wildly varying ways.

Generalizations are seldom helpful.

</comment></comment><comment><USER21> As a parent of a grown ADHD child we have struggled with the drugs losing effectiveness problem for years. One drug will work for a while, then issues like tics, physical, or verbal will start manifesting.

What I found works for my kid was changing medications frequently, it seems to work well at avoidoing the tics and tolerance. Melatonin for sleep worked great for years.

Now that our child is an adult, he finds the he can self regulate his meds well, he only takes them on days when he needs some extra horse power. And he uses Vyvanse for extended study periods and dextroamphetamine for short periods like tests.

Honesty I don't know how most parent cope. My wife is a psychologist who is trained in these issue and its still HARD. Weight gain is still an issue, so make sure you give them everything they can eat, I used to make malts every night. Which was great for him, not so good for me!

</comment><comment><USER22> Depression and IBS have the same problem.

<comment><USER23> This is probably because both are symptoms or at best syndromes instead of diseases.</comment></comment>


Samsung says Galaxy Tab sales are "quite smooth" | Samsung Hub - <AUTHOR> http://www.samsunghub.com/2011/02/01/samsung-wants-to-clear-the-air-says-galaxy-tab-sales-are-quite-smooth/ <comment><AUTHOR> This reminds me so much of the old Emily Litella character that Gilda radner used to play on the Weekend Updated segment of SNL!</comment>


Ask HN: Blog on Interview question re: side projects. - <AUTHOR>

Hi all,
I read a blog linked on HN that basically was about the single best interview question, which was asking about side projects.  The gist of the article was that really good developers/designers always have a side project, or blog - something that they work on during their spare time.
Does anyone remember that? <comment><USER2> The Google one from last week?

If not, try this..

[http://www.google.com/search?hl=en&q=site:ycombinator.co...](http://www.google.com/search?hl=en&q=site:ycombinator.com+single+best+interview+question)</comment>