ADHA, ADD, NE, Letters, letters and more letters

Last November there were headlines that read, "A Fix for Down Syndrome Brains" and " Norepinephrine Boosts Memory in Down Syndrome Mouse Mode" and "Norepinephrine could Reverse Down syndrome".

This was and is fantastic. Looking at the study out of Stanford University, Salahi et al. found that increasing the neurotransmitter, norepinephrine (NE), increased contextual learning. They gave the DS mouse a drug called L-DOPS, which increases norepinephrine and epinephrine. This drug is used in kidney dialysis patients for hypotension. So, it increases blood pressure. What an interesting choice. One would not readily use that drug in children or adults with Down syndrome.

But there are a whole group of drugs that one would use in children and adults. They have been used for 50 years in thousands of children, and they also increase Norepinephrine. What kind of drugs could these be?

ADD/ADHD medications!

Ritalin was introduced in 1960. It was not known at that time how the drug worked, but it is now. It increases the levels of Norepinephrine! According to the Stanford study published November 2009, the Down syndrome mouse model benefitted from increased NE. So, maybe all children and adults with DS would benefit from ADHD meds? Not that they are all diagnosed ADD/ADHD, but this may be the next layer of the brain 'onion'.

F.Y.I. --- Other well known ADD/ADHD drugs are Concerta, Vivance, Focalin XR, Metadate, and Desoxyn

Balancing Brain Chemistry

The idea that there is a cure for Down syndrome bothers some people. Over the weekend, I read a few blogs that say that we cannot remove the extra chromosome from every cell, therefore there cannot be a cure for Down syndrome. It is not about removing an extra chromosome -- our medicine doesn't do that for any medical problem. We treat the symptoms.

What the latest study from Stanford University showed is that 'balancing the brain chemistry', changed how the mice could perform. Treatment or cure for Down syndrome is all about balancing the brain chemistry. But if you think about it, balancing brain chemistry is exactly what psychiatric medicine has evolved into. At one time, you went to the doctor to talk about your problems. Now, you describe a symptom and you are given a prescription to balance the chemistry. It may take some trial and error to get it right, but researchers don't have a mouse model of you. That is where Down syndrome is lucky. They have a little mouse that can help explain what is going on inside their heads.

The other argument against treatment for Down syndrome is that there have not been clinical trials using these psychiatric agents. I would point out that there have not been clinical trials using any medicine commonly given to kids and adults with Down syndrome.

For example, we use antibiotics with Down syndrome and we know they have compromised immune systems. Would we demand a clinical trial before we gave our child Amoxicillin if they had an infection? No, we would just assume that the DS child is similar enough to the average child to safely use the antibiotic.

Have there been clinical trials on the reflux medicine that we give our Down syndrome children? No. Does that stop us from treating the reflux? No.

Have there been clinical trials on ibuprofen or Tylenol that we give our Down syndrome children? No. Does that stop us from giving those medications when they are needed? No.

I looked up clinical trials in Down syndrome and found a vitamin E study, Donepezil (an Alzheimer drug), antioxidant vitamin study, and some growth and thyroid hormone studies.

So, only when we move to try to treat the source of the difficulties is a clinical trial brought up. The source of the slow processing is the brain. The source of the low motor skills is the brain. The source of the low verbal skills is the brain. The source of the poor memory is the brain.

Dr. Craig Garner at Stanford University has been working on the cause of the poor memory in Down syndrome. We now know it is a little receptor called a GABA receptor. Without any treatment the receptor is stuck in the open position in Down syndrome. With some simple chemistry, the receptor can be rebalanced to open and close more normally. This simple chemistry balances the brain chemistry.

Dr. Salahi at Stanford found that the level of norepinephrine is low in subjects with Down syndrome. A common way to restore norepinephrine levels to a more normal level is ADHD medicine.

Dr. Mobley found that the transport system for Nerve Growth Factor was broken so the nerves did not get this necessary support. But when they added it to the nerves, they restarted as if they are lying dormant. To our benefit, a medicine as common as Prozac has been shown to increase another nerve factor chemical (BDNF). This is a fairly easy way to compensate for the brain chemistry imbalance.

Balancing brain chemistry is not new. Many of our friends and loved ones struggle with depression and other brain chemistry imbalances. We understand how they can be helped with the correct medicine. The situation in Down syndrome is the exact same thing; it is a matter of balancing brain chemistry to proper levels.

FANTASTIC! Another way to help Down syndrome

Fantastic!!!! A study from Stanford University was released this week showing that when certain chemicals were increased to a more normal level in the brains of the Down Syndrome mouse, the mouse learned better. The idea that medicine can improve function is the entire theory behind the Changing Minds protocol.

They increased a chemical called norepinephrine which is a neurotransmittor. A neurotransmittor is a chemical that literally jumps across from the end of one nerve to the beginning of another nerve.

The study gave the Down syndrome mouse a drug called droxidopa which is an orally active norepinephrine precursor used for the treatment of orthostatic hypotension. Hypotension is abnormally low blood pressure.

Increasing norepinephrine is a known treatment for other situations. It is used in Attention-deficit/hyperactivity disorder, depression and hypotension. Norepinephrine cannot cross into the brain directly so medicines are used to increase it indirectly.

Increasing norepinephrine in the hippocampus (area of memory and learning in the brain) enhanced cognition in the Down syndrome mouse. So why not use a medicine that increases norepinephrine AND has been used in children for 50 years???? That medicine would be ADHD meds, such as Focalin, Concerta, etc. Why use a medicine that you would have to start from scratch with clinical trials?

We at Changing Minds Foundation have seen real improvement adding ADHD medication for our children with Down syndrome. What this study does, is back up with laboratory findings what we already have seen with the children on the Changing Minds protocol.