Saturday, September 28, 2013

Dr. Dan Rossignol - TACA conference 9-28-2013

Dan Rossignol MD - Rossignal Medical Center


An Update on Evidence-based Obverview of Supplements and Medications for Autism

There is not an FDA approved treatment for Autism.  FDA recommends Risperidone and Aripiprazole are used for irritability

His son was diagnosed with autism at 19 months.  At the time his son was diagnosed the medical community said there was not any treatments - indicated he might have to be institutionalized.  

Dr. Rossignol’s motivation is his two sons.

What is Autism
  • Is classified as a disorder, not a disease
  • Is a spectrum disorder
  • There are no defining biomarkers
  • Is diagnosed solely by behavioral observations: has + and - symptoms
  • Therefore, the diagnosis of autism tells us nothing about the potential causes of the disorder.
  • Symptoms
    • Too Little
      • Speech delay
      • impaired social interaction
      • poor ey contact
      • impaired attention
      • Generally correspond to lower brain activity and cerebral hypoperfusion
    • Too much
      • Hyperactivity
      • Self-stimulatory acitivty
      • Obsessive-compulsive behavior
      • Aggression
      • Generally correspond to increased brain perfusion and activity

Choosing a Treatment
  • We treat metabolic or biochemical abnormalities that may be contributing to behavior; in that sense, we are not treating “autism” or “ADHD”
  • E.G. autism is treated with ABA therapy
  • Use proven treatments based upon biomarkers and evidence-based medicine

Biomarkers
  • Biomarkers help subgroup children and identify metabolic abnormalities that may be treatable
  • Help to individualize treatments

Evidence Based Medicine (EBM)
  • Using the best available evidence to aid clinical decision making
  • Uses strength or level of evidence (LOE)
    • Benefit(s) of treatment
    • Risk(s) of treatment
    • Can apply to diagnostic testing
  • Basis is often randomized controlled trials (RCT), systematic reviews and meta-analysis

Treatments
  • Melatonin
  • Omega-3 Fatty Acids (Fish Oil)
  • Multivitamin/Mineral Supplement
  • Acetylcarnitine (Safe alternative to the use of stimulant drugs)
  • N-Acetylcysteine
  • Medications
    • Naltrexone
    • Propranolol
    • Oxytocin


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