Autism & Bipolar Disorder
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Q:  Autism & Bipolar Disorder

Dear Dr. Phelps,

First, thank you for the excellent site and info.  My question has to do with the possible overlap of neurological or neurochemical bases of Bi-polar II and Autism. Our 10 yr old son is Autistic (onset at 22 months, typical pattern of tactile defensiveness, sensory integration difficulties, flapping, self-stim, odd gestures and sounds - although quite verbal). He has shown a slight improvement with Prozac taken now for 13 mos.

Moreover, both my husband and myself have been diagnosed with Bi-Polar II (mine more depressive, his more rapid cycle) and in my husband's case Prozac when combined with Wellbutrin has shown positive results, again not many although he has been taking this combo for 3 yrs.  In my case, 450 mg of Effexor taken in tandem with Dexadrine also for the past 3 yrs has been virtually no use: 2 attempted suicides, acute depression, chronic insomnia.

Since we all three have biochemical challenges that appear to be similar, could there not be some overlap between Autism and Bi-Polar in more ways than just in terms of symptomology?  Should I have our son looked at anew from the perspective of our recent Bi-Polar diagnosis?  or ourselves in terms of his of Autism?

Thanking you for your time and consideration,

Dear Ms/Mr. H' -- 
Well, when you don't know anything, try Google, right?  So, searching "bipolar autism" to see what's out there.... I found a letter I wrote on this site a while back, saying I don't know anything -- very useful, especially since the single link in there is broken now anyway. 

But here are a few things that emerged from a new search on Google, and then the same search terms entered on Pub Med (as you can see, the answer is still "I don't know anything about this").  First, here's an article I'll bet you've found already, associating autism with the "reelin" gene, suggesting as well that reelin has been associated with bipolar disorder:  Keller .  There is another report that does indeed associate reelin with bipolar disorder: Fatemi .  However, I'm not aware of major news breaking about reelin and bipolar disorder or autism, since these 1991 publications, so it's not clear how much value to place on these individual pieces of research (on the other hand, this is not a rail I've got my ear on most of the time, either). 

There is an open trial of Depakote, as you know one of the most commonly used mood stabilizers, in 14 kids with autism (Hollander) in which 70% got better -- but no explicit connection drawn, in the abstract at least, between the two conditions.   

That's it for the search this time.  I did note while surfing around that there seemed to be other cases, e.g. one case report from Brazil, of bipolar disorder and autism showing up in the same kids.  Obviously there was an additional case in the one other letter to this site, which you'll find strikingly similar to your circumstance if you haven't seen it already. 

 So, there seems to be some sort of connection, possibly, but again nothing solid about that possible connection -- yet.  

Dr. Phelps

Published April, 2003


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