Autism, Iron and Aggression

In perfect timeliness, my AAP Smart Brief linked email me to an article in Family Practice News that discussed how antipsychotic medication sometimes prescribed for aggression problems in children diagnosed with autism may cause iron deficiency.

The article said, ” Children with autism spectrum disorders already are at increased risk of iron deficiency, previous studies have shown.”

Then, it said that these new findings indicate that two second-generation antipsychotics that are approved to treat aggression sometimes associated with autism spectrum disorders – risperidone and aripiprazole- seem to worsen anemia in these children.

Now, consider that in the Journal Of Orthomolecular Medicine, Melvyn R. Werbach, M.D., wrote:

“Iron is also needed as a co-factor for the enzymes which metabolize not only dopamine, but also serotonin and norepinephrine, which also have a potent influence on behavior.

Evidence is now emerging that iron deficiency may be an important contributor to the aggressive behavioral syndrome. Among adolescent males, iron deficiency has been shown to be directly associated with aggressive behavior. Moreover, in a population of incarcerated adolescents, the prevalence of iron deficiency was nearly twice that found in their non-incarcerated peers.”

So, as a parent, if my child were about to be prescribed an antipsychotic medication to treat aggressive behavior, I would have to take pause.

Is that really the first step?

Given that iron deficiency is being recognized as a viable cause of aggressive behavioral problems, given that these medications can make that deficiency worse and given that children with autism are already more likely to  have iron deficiency, should the first course of action be to prescribe an psychiatric medication?

Keep in mind that these psychiatric medications that are often prescribed to children with autism come with potential side effects that include: agitation, anxiety, manic reaction, aggressive reaction, depression, apathy, and catatonic reaction for one medication or depression, schizophrenic reaction, hallucination, hostility, paranoid reaction, suicidal thought, manic reaction, delusions, panic attack, manic depressive reaction, obsessive thought, derealization and visual hallucination in the other medication.

How many children of ours are given complete nutritional screenings with blood work prior to being prescribed psychiatric medicine for behavior problems? How often do our children’s doctors evaluate dietary triggers?

When are our children going to be seen as whole people? When will common sense return to medicine?

For further reading on the impacts of malnutrition as early as age three on behavior, check out this article.