Text1

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.”
(...)
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. 

Texto 

TRUMP-KIM SUMMIT: DONALD TRUMP VOWS TO 'END WAR GAMES' IN 'NEW HISTORY' WITH NORTH KOREA

By Ben Riley-Smith, US editor, in Singapore 13 JUNE 2018 • 8:10AM – The Telegraph

Donald Trump unexpectedly suspended "war games" on the Korean peninsula yesterday as he convinced Kim Jong-un to back "complete denuclearisation" in a written agreement. The US has been carrying out joint military exercises for years in the region as a signal of its military alliance with Seoul (South Korea), and as a show of strength against North Korean aggression.

The US president said in a press conference after the Singapore summit: "It is a very great day, it is a very great moment, in the history of the world." He predicted Kim would start denuclearise "very quickly" and revealed that the North Korean leader had already agreed to destroy a missile engine testing site. 

The climax of Mr Trump‘s meeting with Kim — the first between a sitting North Korean and American leader — was the signing of a joint agreement. The 400-word statement followed more than four hours of talks, first between the leaders one-on-one and then with a wider group of advisers. 

It read: "President Trump and Chairman Kim Jong-un conducted a comprehensive, in-depth, and sincere exchange of opinions on the issues related to the establishment of new United States - North Korea relations and the building of a lasting and robust peace regime on the Korean Peninsula. 

The statement went on to list four specific pledges that both Mr Trump and Kim agreed to stand by: The first was that both countries would establish "new relations" in the pursuit of "peace and prosperity" — an attempt to draw a line under the insults and threats of last year. The second said that America and North Korea would "join their efforts to build a lasting and stable peace regime on the Korean Peninsula". The third said that Kim‘s regime "commits to work toward complete denuclearisation of the Korean Peninsula" — a key demand from the Americans. And the fourth promised that the remains of fallen US soldiers who died fighting in the Korean War would be repatriated to the United States. 

Mr Trump said he "absolutely" would invite Kim to the White House and expressed enthusiasm for visiting North Korea, but said no dates had been set. Mr Trump also praised the leaders of Japan, South Korea and China as well as Kim himself for the progress made on the issue of denuclearisation. 

Source: < https://goo.gl/dEim38> Date of retrieval: June 13th, 2018.

         Drinking coffee could help you live longer Coffee not only helps you feel full of beans, it might add years to your life as well, two major studies have shown. Scientists in Europe and the US have uncovered the clearest evidence yet that drinking coffee reduces the risk of death.

         One study of more than half a million people from 10 European countries found that men who downed at least three cups of coffee a day were 18% less likely to die from any cause than non-coffee drinkers. Women drinking the same amount benefited less, but still experienced an 8% reduction in mortality over the period measured.

        Similar results were reported by American scientists who conducted a separate investigation, recruiting 185855 participants from different ethnic backgrounds. Irrespective of ethnicity, people who drank two to three cups of coffee daily had an 18% reduced risk of death.

        Each of the studies, both published in the journal Annals of Internal Medicine, showed no advantage from drinking either caffeinated or decaffeinated coffee. Experts believe the antioxidant plant compounds in coffee rather than caffeine are responsible for the life-extending effect. Previous research has suggested that drinking coffee can reduce the risk of heart disease, diabetes, liver disease, and some cancers.

         Dr Marc Gunter, from the International Agency for Research on Cancer, who led the European study with colleagues from Imperial College London, said: “We found that higher coffee consumption was associated with a lower risk of death from any cause and specifically for circulatory diseases and digestive diseases. Importantly, these results were similar across all of the 10 European countries, with variable coffee drinking habits and customs. Our study also offers important insights into the possible mechanisms for the beneficial health effects of coffee.”

(www.huffingtonpost.co.uk, 11.07.2017. Adaptado.)