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Acetaminophen and autism.

Acetaminophen (also called paracetamol) may be a factor in the rising incidence of autism, according to numerous studies. Stephen Schultz, PhD, investigated acetaminophen as a doctoral student because of his experience with his son, who had regressed into autism after receiving an MMR vaccine: "I remembered that Nathan had gotten so sick from the MMR vaccine and how I had given him so much acetaminophen. Perhaps there was something about acetaminophen.'" Schultz found that the first cases of regressive autism began about the time that acetaminophen-type drugs appeared on the market. Moreover, autism incidence declined in 1982 and 1986, the years in which acetaminophen use declined because of poisoning scares. Schultz's 2008 retrospective survey of parents with and without autistic children also showed a strong correlation. Schultz told William Parker, PhD, '"I did not see a direct association with any of the vaccines themselves. It was only the combination of acetaminophen and the MMR vaccine which increased autism risk.'" Ibuprofen use was not associated with autism. Other researchers have also seen a link between acetaminophen use in children and autism. A 2013 study documents a rise in autism rates when acetaminophen became standard pain-relief treatment for infant boys undergoing circumcision (Bauer A et al. Environmental Health. 2013;12[1]:41). In a SafeMinds blog post, Parker says that acetaminophen is the only drug in a class of coal-tar-derived drugs that has not been discontinued because of toxicity.

Prenatal exposure to acetaminophen also correlates to autism rates according to two large epidemiological studies. Children whose mothers used acetaminophen during pregnancy were more likely to have problems with attention, emotions, aggression, and gross motor skills than children whose mothers didn't use the drug, according to a 2013 Norwegian study. A 2015 Danish national birth cohort study, involving 64,322 children and mothers, found an association between maternal use of acetaminophen during pregnancy and autism spectrum disorders with hyperkinetic symptoms.

The authors report, "Longer duration of use (i.e., use for >20 weeks in gestation) increased the risk of ASD or infantile autism with hyperkinetic symptoms almost twofold."

Laboratory research supports these epidemiological findings. A 2011 in vitro study, led by Schultz, found that an acetaminophen metabolite, para-aminophenol, kills mouse cortical neurons. Para-aminophenol is responsible for acetaminophen's pain-relieving effects. "Acetaminophen itself was not toxic to developing mouse cortical neurons at therapeutic concentrations of 10-250 pg/ml," say Schultz et al. "However, concentrations of p-aminophenol from 1 to 100 pg/ ml produced significant (p<0.05) loss of mouse cortical neuron viability at 24 hr compared to the controls." The authors point out that acetaminophen has never been shown to be safe for young children and "... its effect on embryonic neurons and brain development are unknown."

William Parker, PhD, whose research at Duke University Medical Center focuses on immune function, advises parents to avoid acetaminophen and drugs that contain acetaminophen during pregnancy and when treating their children for pain or fever. "Maybe in the future, what we now call autism will be a condition of historical interest known as 'acetaminophen-induced neurodevelopmental disorder,"' he writes. "... What we do know is that acetaminophen is bad for a fetus and bad for a baby."

Liew Z, Ritz B, Virk J, Olsen J. Maternal use of acetaminophen during pregnancy and risk of autism spectrum disorders in childhood: A Danish national birth cohort study. Autism Res. Dec. 21, 2015.

Parker W. Acetaminophen as a cause of the autism pandemic? It makes absolutely no sense ... at first [blog post]. September 11, 2015.

Schultz S, DeSilva M, Gu TT, Qiang M, Whang K. Effects of the analgesic acetaminophen (paracetamol) and its para-aminophenol metabolite on viability of mouse-cultured cortical neurons. Basic Clin Pharmaco Toxicol. February 2012; 110(2):141-144.

briefed by Jule Klotter
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Title Annotation:Shorts; role of acetaminophen in autism development
Author:Klotter, Jule
Publication:Townsend Letter
Date:Oct 1, 2016
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