Less anxiety for autistic teens

How medication in the gut can reduce panic

Around 2% of Dutch children aged between 4 and 12 have autism. This amounts to 31 thousand children. Currently a medication is being developed that can lessen some autistic symptoms in teenagers. Even though this medicine is still in the testing phase, so far the results are hopeful. Anxiety decreased in these children, and the medicine did not cause any serious side effects.

At the beginning of this year new results about this medicine were published. Right now the medicine is still being developed. Researchers from the American University Caltech have proven first in mice that this medication reduces anxiety symptoms. After this success they checked if this worked the same in human patients. This study, containing 30 autistic teens, showed multiple positive results. The most important of these was that the pill helped against the anxiety symptoms the autistic teens had. But, also very important, the medication did not cause any harmful side effects, which is essential when developing new medicines.

Signals between gut and brain

A final result seen in the research was that the medicine worked as it was supposed to, which is by blocking a certain particle in the gut. So what kind of particle needed to be blocked? These particles are usually responsible for causing anxiety symptoms that occur often in autistic children. How this works is because your gut can communicate with your brain. This happens in different ways: through nerves, through blood and through your immune system. Through this system particles in the gut can send signals to the brain. The signals can cause all kinds of effects in the brain, and can sometimes influence autism. The particles that send these signals from the gut to the brain are made by bacteria. Bacteria live in your gut and perform a lot of different functions. They digest your food, fight against diseases and much more. But, not all bacteria are good for you, and some gut bacteria can cause sickness. All these good and bad bacteria together are called the gut microbiome, or gut flora. Autistic children have bacteria within their gut flora that send signals to the brain that cause, for example, anxiety symptoms. Stopping these signals will thus reduce anxiety. Therefore, this medicine blocks specifically those bacteria-produced particles in the gut that would lead to anxiety symptoms in the brain. This process is also explained in the figure below.

The left shows the original situation for an autistic child: gut bacteria produce a particle that causes anxiety in the brain. In the situation with medication (on the right) this particle is blocked. This lessens the anxiety.

Whether or not to cure autism

But do people want medication like this? Recently the autistic community has voiced out about how mental disabilities should be accepted by society. The non-profit ASAN (Autistic Self Advocacy Network) has been created to defend the rights of this community. They want autistic people to be involved in decisions that involve autism. Their motto is that not everyone is the same, but they don’t need to be. They do not think a cure for autism is necessary. Handicaps are a natural part of humans and should be accepted. This is something that needs to be taken into account if this medicine becomes available. If this is seen as a cure to autism it might work counteractive and offend the people it intends to help.

But, even though a change might happen in how society treats autistic people, at this time there are still a lot of autistic children that want to be more like the others. They are focussed on “getting better” and learning how to best interact with the people around them. Especially for teenagers it is still very difficult being “different”. Another issue for teens is that anxiety can more easily turn into panic. This panic can be caused by situations they have no influence on, making it very difficult to deal with it. Therapies and strategies exist to help autistic children that have symptoms like these, but in the worst cases this is not enough. Especially for these situations the medication becoming available would be welcome. Teens could then use this medicine against extreme anxiety symptoms to have a more full life. The choice that medication is the best option will be made by the autistic teens and their parents.

Future perspective

If the medicine will be further developed by the researchers from Caltech it could become available in the future for autistic teens. This medication could help them deal with their anxiety and panic symptoms and could make their life a little easier. This does not mean this pill can cure autism, and not that this is the goal. A society more inclusive to people with a mental disability would be the ideal solution, but until that time this medication could be one of the options for autistic teens to go through life without extreme panic.

Sources

Scientific article about the medicine: Stewart Campbell, A., Needham, B.D., Meyer, C.R. et al. Safety and target engagement of an oral small-molecule sequestrant in adolescents with autism spectrum disorder: an open-label phase 1b/2a trial. Nat Med (2022). https://doi-org.proxy.library.uu.nl/10.1038/s41591-022-01683-9

Centraal Bureau voor de Statistiek (2021). Autisme onder 4-12 jarigen.

Carabotti, M., Scirocco, A., Maselli, M. A., & Severi, C. (2015). The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals of gastroenterology, 28(2), 203–209.

ASAN. https://autisticadvocacy.org

Life as an Autistic Teen (Autism, ADHD and Anxiety) https://www.youtube.com/watch?v=D4Hapmm9YiY

Anxiety: autistic children and teenagers. https://raisingchildren.net.au/autism/health-wellbeing/mental-health/anxiety-asd