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Autism's Drug Problem

Many people on the spectrum take multiple medications, which can lead to serious side effects and may not even be effective

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. “One time, he rolled himself up into the carpet like a burrito and wouldn’t come out until I got there,” Melissa recalls. (All families in this story are identified by first name only, to protect their privacy.)
Connor was prescribed his first psychiatric drug, methylphenidate (Ritalin), at age 6. That didn’t last long, but when he was 7, his parents tried again. A psychiatrist suggested a low dose of amphetamine and dextroamphetamine (Adderall), a stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD). The drug seemed to improve his time at school: He was able to sit still for longer periods of time and focus on what his teachers were saying. His chicken-scratch handwriting became legible. Then, it became neat. Then perfect. And then it became something Connor began to obsess over.
“We were told that these are the gives and takes; if it’s helping him enough to get through school, you have to decide if it’s worth it,” Melissa says. It was worth it — for a while.
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. So after a month or two, his psychiatrist added a second medication — guanfacine (Intuniv), which is commonly prescribed for ADHD, anxiety and hypertension, but can also help with insomnia. The psychiatrist hoped it might both ease Connor’s afternoons and help him sleep.
In some ways, it had the opposite effect. His afternoons did get slightly better, but Connor developed intense mood swings and was so irritable that every evening was a struggle. Rather than simply tossing and turning in bed, he refused to even get under the covers. “He wouldn’t go to bed because he was always angry about something,” Melissa says. “He was getting himself all wound up, carrying on, getting upset at night and crying.”
wound up, carrying on, getting upset at night and crying.” After seven months, his parents declared the combination unsustainable. They swapped guanfacine for over-the-counter melatonin, which helped Connor fall asleep with no noticeable side effects. But within a year, he had acquired a tolerance for Adderall. Connor’s psychiatrist increased his dosage and that, in turn, triggered tics: Connor began jerking his head and snorting. Finally, at his 9-year physical, his doctor discovered that he’d only grown a few inches since age 7. He also hadn’t gained any weight in two years; he’d dropped from the 50th percentile in weight to the 5th. That was the end of all the experiments. His parents took him off all prescription drugs, and today, at almost 13 years old, Connor is still medication-free. His tics have mostly disappeared. Although he has trouble maintaining focus in class, his mother says that the risk-benefit ratio of trying another drug doesn’t seem worth it. “Right now we’re able to handle life without it, so we do.”
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For Connor, eliminating prescription drugs was difficult, but doable. For others, multiple medications may seem indispensable. It’s not unusual for children with autism to take two, three, even four medications at once. Many adults with the condition do so, too. Data are scant in both populations, but what little information there is suggests multiple prescriptions are even more common among adults with autism than in children. Clinicians are particularly concerned about children with the condition because psychiatric medications can have long-lasting effects on their developing brains, and yet are rarely tested in children.
In general, polypharmacy — most often defined as taking more than one prescription medication at once — is commonplace in people with autism. In one study of more than 33,000 people under age 21 with the condition, at least 35 percent had taken two psychotropic medications simultaneously; 15 percent had taken three.
“Psychotropic medications are used pretty extensively in people with autism because there aren’t a lot of treatments available,” says Lisa Croen, director of the Autism Research Program at Kaiser Permanente in Oakland, California. “Is heavy drug use bad? That’s the question. We don’t know; it hasn’t been studied.”

Disponível em: <https://www.scientificamerican.com/article/autisms-drug-problem/>. Texto adaptado.

Read the text and answer the question.

What Happens to Your Body When You Drink Milk Every Day

Milk (and dairy in general) gets the blame for a lot of unwanted health outcomes. We're sure you've heard that dairy causes acne, increases inflammation and can even be the reason you're not losing weight. Spoiler: For those who aren't lactose-intolerant or allergic to dairy, research doesn't back up those claims. In fact, there are actually some impressive benefits that come with drinking a nutritious glass of milk.

Your Bone Health Might Improve

Not only is milk a great vegetarian protein source, but it's also packed with calcium and vitamin D—two nutrients that are vital for bone health. Calcium is a mineral needed to build and maintain strong bones, and vitamin D helps our body absorb calcium from the foods we eat. Since milk is a great source of both of thesenutrients, it's one of the best things to keep in your diet for bone health throughout life.

You Might Reach Your Weight Loss Goals

There are lots of misconceptions about how drinking milk can affect weight, but research shows regular consumption probably won't hurt your cause if you're trying to lose weight or maintain a healthy weight. This is largely due to the satisfying combination of carbohydrates, protein and fat found in milk. Protein and fat can help make milk super filling, which can help with weight loss. Carbs give you energy and help your body function at its best. When you're more satisfied from the foods you eat, it's easier to honor your hunger and fullness levels and stick to a healthy, balanced eating pattern.

A meta-analysis of randomized controlled trials (the gold standard of research) published in the journal Nutrients found that including dairy in a calorie-restricted diet resulted in greater weight loss and fat loss, while reducing loss of lean muscle. This doesn't mean milk is a miracle weight-loss food, though. Another review of studies found that consuming milk or other dairy products didn't result in significant weight loss, but didn't lead to weight gain either. If your goal is to lose weight or maintain a healthy weight, drinking a glass of milk each day might help, if it's a food you enjoy. You Might Lower Your Risk of Cognitive Decline

The impressive nutrition profile of milk could be a reason why it can help you stay more mentally sharp as you age. A 2021 review of studies published in Nutrition & Metabolism found that milk intake was connected with a decreased risk of Alzheimer's disease. Another study published in 2020 in the journal Nutrients found that skimmed dairy, fermented dairy and buttermilk were associated with better executive functioning. So adding some milk to your morning oats or as a side to a snack may help boost your brain health.

Researchers hypothesize that one reason milk might support healthy aging is the nutrition that it provides. Milk is a good source of calcium, protein and vitamin B12, all of which are critical nutrients for older adults.

The Bottom Line

If you aren't lactose-intolerant or allergic to dairy, it's totally OK to enjoy a regular glass of milk each day. From improving bone health to helping mitigate cognitive decline, drinking milk and incorporating other dairy items into your diet can come with some health benefits. As with any food, remember that moderation is key (an 8-ounce serving of milk probably wouldn't completely fill many of the glasses in your cupboard). Since there are dairy farmers all across the U.S., try choosing milk that is produced locally. Making a connection with a local farmer can help you get a better-quality product that takes less of a toll on the environment, too.

FONTE: Adapted from: https://www.eatingwell.com/article/7961444/what-happensto-your-body-if-you-drink-milk-every-day/#:~:text=Not%20only%20is% 20milk%20a,from%20the%20foods%20we%20eat.

T E X T

EL TIGRE, Venezuela — Thousands of workers are fleeing Venezuela’s state-owned oil company, abandoning once-coveted jobs made worthless by the worst inflation in the world. And now the hemorrhaging is threatening the nation’s chances of overcoming its long economic collapse.

Desperate oil workers and criminals are also stripping the oil company of vital equipment, vehicles, pumps and copper wiring, carrying off whatever they can to make money. The double drain — of people and hardware — is further crippling a company that has been teetering for years yet remains the country’s most important source of income.

The timing could not be worse for Venezuela’s increasingly authoritarian president, Nicolás Maduro, who was re-elected last month in a vote that has been widely condemned by leaders across the hemisphere. Prominent opposition politicians were either barred from competing in the election, imprisoned or in exile.

But while Mr. Maduro has firm control over the country, Venezuela is on its knees economically, buckled by hyperinflation and a history of mismanagement. Widespread hunger, political strife, devastating shortages of medicine and an exodus of well over a million people in recent years have turned this country, once the economic envy of many of its neighbors, into a crisis that is spilling over international borders.

If Mr. Maduro is going to find a way out of the mess, the key will be oil: virtually the only source of hard currency for a nation with the world’s largest estimated petroleum reserves. But each month Venezuela produces less of it. Offices at the state oil company are emptying out, crews in the field are at half strength, pickup trucks are stolen and vital materials vanish. All of this is adding to the severe problems at the company that were already acute because of corruption, poor maintenance, crippling debts, the loss of professionals and even a lack of spare parts.

Now workers at all levels are walking away in large numbers, sometimes literally taking piecesof the company with them, union leaders, oil executives and workers say.

A job with Petróleos de Venezuela, known as Pdvsa, used to be a ticket to the Venezuelan Dream. No more.

Inflation in Venezuela is projected to reach an astounding 13,000 percent this year, according to the International Monetary Fund. When The New York Times interviewed Mr. Navas in May, the monthly salary for a worker like him was barely enough to buy a whole chicken or two pounds of beef. But with prices going up so quickly, it buys even less now.

Junior Martínez, 28, who has worked in the oil industry for eight years, is assembling papers, including his diploma as a chemical engineer. His wife and her daughter left three months ago to earn money in Brazil. “I get 1,400,000 bolívars a week and it isn’t even enough to buy a carton of eggs or a tube of toothpaste,”Mr. Martínez said of his salary in bolívars, Venezuela’s currency.

Mr. Martínez’s father, Ovidio Martínez, 55, recalled growing up here when the oil boom began. He cried as he spoke of his son’s determination to leave the country. “You watch your children leave and you can’t stop them,” the elder Mr. Martínez said, fighting back tears. “In this country, they don’t have a future.”

In El Tigre, hundreds of people stood in line one recent morning outside a supermarket, many waiting since the evening before to buy whatever food they could.

From: www.nytimes.com/June 14, 2018. Adapted.