Autism

The marketing of Risperdal and how atypical antipsychotics became a multi-billion-dollar industry – a shockingly eye-opening article!

August 22, 2025 By Trudy Scott 2 Comments

Even though I’m very aware this happens, this shockingly eye-opening article by Lydia Green is the best explanation I’ve heard….

I didn’t set out to shape the field of psychiatry. I was just a copywriter working in pharmaceutical advertising. But over time, I found myself at the center of a campaign that would help transform how mental illness—and its treatment—are understood in the U.S. This is the story of how we marketed one drug, Risperdal, and how that effort helped turn atypical antipsychotics into a multi-billion-dollar industry.

If you’ve ever wondered how this powerful class of drugs ended up being prescribed for everything from adolescent mood swings to agitated nursing home patients, you’re not alone. The rise of atypical antipsychotics was a business and marketing phenomenon—driven in part by a wave of pharmaceutical mergers in the 1990s. First introduced for schizophrenia, atypical antipsychotics were promoted as more effective and safer than older drugs like Haldol or Thorazine.

While journalists and regulators have addressed this issue, I want to share my memories of marketing Risperdal—the first widely prescribed atypical antipsychotic. This is the story of how we promoted Risperdal not just as a medication, but as a revolution in psychiatric care. It’s also the story of how we redefined schizophrenia, rewrote the safety narrative of antipsychotics, and helped drive one of the most successful (and concerning) pharmaceutical launches in history.

It was also my first realization of the immense power marketers have to shape their version of the truth—and how I eventually came to question the very system I helped build.

This is an excerpt from the excellent article recently published on the Mad in America site. We all need to be aware what happened with this medication and is still happening. It’s so wrong and is just heart-breaking to think how individuals and their families were manipulated and impacted. Unfortunately it’s very likely also happening with many other block-buster medications too – like Ozempic (for weight-loss), Evenity (for osteoporosis) and more.

In this blog, I share stories from social workers and psychologists who were working in the field at time, the overprescribing of atypical antipsychotics to children and teens in the mid-1990s and now, and the powerful effects of tryptophan, GABA, other nutrients and diet for anxiety, agitation, rage and sleep issues in autism, dementia and ADHD.

You can read the full article here – Confessions of an Ad Writer: How I Helped Turn Atypical Antipsychotics into a Billion-Dollar Industry.

Be sure to read some of the many comments from individuals and families who bore the brunt of this. It’s heartbreaking.

Stories from individuals who were working in the trenches at the time

I shared this article on Facebook and here is some of the feedback I received from the community. Laura Ann’s response:

Thank you for sharing this article. I can remember when I was fresh out of my grad social work program and was working in child psychiatry at the University of Maryland, our docs were pushing this drug for young children with ADHD and conduct disorder. Unbelievable! These companies and their executives should be criminally prosecuted.

We tend to think of these scandals as something that happened but aren’t currently happening. I think we will be reading similar articles about GLP-1’s.

I appreciate her for sharing what she was seeing as a social worker at the time. This is so sad and so wrong. I agree that these companies should be prosecuted. Instead they pay massive fines which are part of their marketing and just-doing-business budget, and continue as before.

Unfortunately Laura Ann is spot on, as much of this continues with Risperdal and other psychiatric meds and it’s already happening with GLP-1s. I share more on this below.

Elizabeth Mary’s response:

Just reading your post gave me chills and made my stomach turn. I worked with folks with developmental disabilities during this time period, I had for years! I watched as the antipsychotics and various psych meds infiltrated the group homes and joined a team of co-workers to fight it. We lost. It was disgusting. And I had no idea all this was happening in the background

My heart breaks for these individuals and their families. Bravo to her for trying to fight it and I appreciate her for sharing what she saw happening.

And this feedback from someone else in the community:

This drug was pushed on individuals with ASD (autism spectrum disorder)! Probably still is! Very sad!

I am a retired psychologist who worked primarily with individuals with developmental disabilities. I saw it all the time. The “medical model” was used a lot, meaning many saw psychiatrists and/or PCPs (primary care providers) who prescribed these meds. It has a long history.

Overprescribing of atypical antipsychotics and other psychiatric medications to children and teens – then and now

As mentioned above, I’ve been aware for some time that there is overprescribing of psychiatric medications to children and teens. In one of my interviews on an Anxiety Summit, “Psychiatric Medications in Children and Teens” with Dr. Nicole Beurkens, we discuss these results from this 2019 paper, Current Pattern of Psychiatric Comorbidity and Psychotropic Drug Prescription in Child and Adolescent Patients:

Our study indicates that the rate of presentation to child and adolescent psychiatry outpatient clinics is increasing, and rates of diagnosis and initiation of psychiatry drugs are high among the presented children.
The prevalence of ADHD shows an increase in males and females in our country, and psychiatric polypharmacy (multiple medications) has reached significant rates.

Keep in mind that Lydia Green shared her marketing work began in the mid-1990s, about 25 years before the above paper was published.

Unfortunately not much has changed. This 2025 paper from Swedish authors reports that the “number of prescriptions to children aged 5-17 years has increased” and that “most prescribed drugs were risperidone [Risperdal] and aripiprazole.”

This 2025 paper report that in a group of Australian children with intellectual disability, autism spectrum disorder and cerebral palsy, “risperidone was the most prescribed antipsychotic medication” and it was often prescribed off-label.

Similar increases in antipsychotic prescriptions are also reported in children and teens in Israel in 2025. The list of papers goes on and on and there are similar papers for dementia and other conditions.

There are versions of this story about a lot of diseases: osteoporosis is another one

Melissa’s response to the Risperdal article was this: “Makes you wonder about therapies they are pushing today.” It’s creating awareness which is what we need and she is asking a great question. Yes – there are many versions of this story about other medications.

Here is a perfect quote from this 2009 article: How A Bone Disease Grew To Fit The Prescription

There’s a powerful economic incentive for pharmaceutical firms to expand the boundaries of the use of different therapies. So whether you consider treatments for osteoporosis or treatments for depression or treatments for high cholesterol — in all of these settings — pharmaceutical firms stand to benefit if the therapies for these diseases are broadly used, even if they’re used among people who have very mild forms of these diseases.

In this same article, Caleb Alexander, a pharmaco-epidemiologist at the University of Chicago, is writing about the marketing of osteoporosis medications and says “the dynamic is well understood.” But all this applies equally to the marketing of all medications i.e. “There are versions of this story about a lot of diseases.”

Dubious marketing by the makers of Ozempic and Wegovy (GLP-1s for weight loss)

This is happening right now for GLP-1s. There were already reports in 2023 about dubious marketing by Novo Nordisk, the makers of Ozempic and Wegovy:

In Great Britain, the company has paid within three years a total of around 21.7 million pounds (24.7 million euros) to experts and organisations including important opinion leaders who have since touted semaglutide as a “game changer” in obesity in a campaign described as an “orchestrated PR campaign.

Sadly I expect their marketing campaigns to run unchecked and get more and more sophisticated, with unsuspecting consumers being taken advantage of and harmed.

Families are not aware of the powerful effects of tryptophan, GABA, other nutrients and diet

My goal is to try and change this lack of awareness so families and individuals can explore other options when they are faced with decisions about some of these medications.

Instead of using antipsychotics for a family member with dementia or Alzheimer’s who is experiencing agitation, aggression and anxiety, consider tryptophan and melatonin, and GABA:

Instead of using antipsychotics, explore the use of 5-HTP/tryptophan and/or GABA for kids with ADHD:

Instead of antipsychotics and other psychotropic medications in autism, explore tryptophan and GABA:

This is by no means a conclusive approach to addressing these symptoms in dementia/Alzheimer’s, ADHD and autism. We also need to consider and address diet, other nutritional imbalances, infections, gut health, toxins and much more.

Additional resources when you are new to using GABA and tryptophan as supplements

As always, I use the symptoms questionnaire to figure out if low GABA or low serotonin or other neurotransmitter imbalances may be an issue.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control (this is covered in an entire chapter too), sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support. You can sign up to be notified when the next live launch is happening.

If you need serotonin support, the Serotonin QuickStart Program is a good place to get help. This is also a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Wrapping up and your feedback

I appreciate Lydia for sharing this and enlightening us, and Mad in Arica for inviting her to do the article. And I appreciate community members for sharing and allowing me to share on this blog

Have you or a family member been the victim of the overprescribing of atypical antipsychotics ?

Have you seen this overprescribing of atypical antipsychotics happening in the work you do as a social worker, psychologist, doctor or other health professional?

Are you surprised to learn about similar strategies being used for marketing osteoporosis and GLP-1 medications?

Feel free to share and ask your questions below.

“A catatonic woman awakened after 20 years. Her story may change psychiatry.” (Her schizophrenia was an untreated autoimmune disease)

June 16, 2023 By Trudy Scott 8 Comments

Today I’m sharing some highlights from a recent eye-opening article in the Washington Post: A catatonic woman awakened after 20 years. Her story may change psychiatry

Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself.

April was diagnosed with a severe form of schizophrenia

April was hospitalized, medicated and eventually institutionalized. It got to the point where she no longer recognized her family and she became catatonic, “unmoving, unblinking and unknowing of where or who she was.”

Twenty years after April’s original diagnosis it was discovered that she has an autoimmune condition. Dr. Sander Markx is director of precision psychiatry at Columbia University and I have so much admiration for his dedication to the field and the fact that he facilitated this testing and discovery so long after meeting April, when he was a student:

Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.

After months of targeted treatments – and more than two decades trapped in her mind – April woke up.

April’s transformation is truly heartwarming and it’s wonderful that the doctors plan to do similar testing and offer similar treatments for others living with schizophrenia who are in mental health institutions in New York State.

Researchers in other countries are making similar connections and it’s really exciting to read that they are recognizing that “underlying autoimmune and inflammatory processes may be more common in patients with a variety of psychiatric syndromes than previously believed.”

We can and should be doing better when looking for root causes

I believe we can and should be doing better when it comes to looking for root causes. Many individuals may have an autoimmune/inflammatory condition and many may have other root cause/s. If I was on an advisory panel these would be my recommendations:

Use this powerful outcome to really turn psychiatry on its head and screen for lupus and other autoimmune conditions in every single person with schizophrenia. Dr. Markx “believes highly sensitive and inexpensive blood tests to detect different antibodies should become part of the standard screening protocol for psychosis.”
Do the same for every single person with mental illnesses and illnesses with a behavioral aspect – including anxiety, depression, bipolar, OCD/obsessive compulsive disorder. ADD/ADHD, autism/ASD (autism spectrum disorders), developmental disorders and neurological disorders.
Go beyond autoimmune screening and do a comprehensive functional medicine and nutritional deficiency assessment for every single person, including low serotonin, low GABA, low vitamin D, low zinc, low vitamin B6, hormone imbalances (sex hormones, adrenals, thyroid health), gut health, liver health etc. This includes testing for infections (such as Lyme and strep), looking at toxin exposure (phthalates, mold, heavy metals) and medication side effects.

If you’re new to the concept of root causes and functional medicine/nutritional testing these two blogs will be helpful. They are specific to anxiety because I work with anxious individuals but much of it can also be applied to other mental health and even physical health conditions (like rheumatoid arthritis and say multiple sclerosis):

Functional medicine and nutrition for maintaining symptom resolution in the long term

As you read in the article, April received “short, but powerful “pulses” of intravenous steroids for five days, plus a single dose of cyclophosphamide, a heavy-duty immunosuppressive drug typically used in chemotherapy and borrowed from the field of oncology. She was also treated with rituximab, a drug initially developed for lymphoma.”

Incredibly, she recovered completely and was eventually discharged from the psychiatric hospital and has been living in a rehab center for 3 years. Unfortunately “she has recently regressed because she was not receiving adequate maintenance care.”

I see the next step for April and others like her, is maintaining resolution of symptoms in the long term. This is where functional medicine and nutrition shines.

The ISNPR shared this about Nutritional psychiatry in 2015 in a letter published in World Psychiatry, the official journal of the World Psychiatric Association:

In addition to dietary modification, we recognize that nutrient-based (nutraceutical) prescription has the potential to assist in the management of mental disorders at the individual and population level.

In other words, diet and nutrient-based approaches need to be included for mental health treatment and for prevention. One of many examples is the ketogenic diet which has been shown to reduce auditory hallucinations and delusions in those with schizophrenia. Another is the low carb diet helping to reduce bizarre intrusive thoughts. And the SMILES trial was the first randomized controlled trial to show that dietary improvement can actually treat depression.

Specific nutrients can be very powerful too. One example is a case where a woman in my community experienced a drastic reduction in intrusive thoughts, anxiety and fears (and better sleep) with GABA, tryptophan, 5-HTP and the pyroluria protocol (zinc, vitamin B6 and evening primrose oil). More on the blog. Intrusive thoughts can be alleviated with a similar combination of nutrients and by addressing hormonal imbalances too.

These blogs/research illustrate a few of the many root causes of schizophrenia and psychosis other than lupus:

When it comes to autoimmunity in general I refer you to the work of Dr. Tom O’Bryan, Dr. Izabella Wentz, Dr. Terry Wahls, Dr. Amy Myers and others who teach about using functional medicine and diet for reversing a number of different autoimmune conditions.

The above approaches can all be explored and used when individuals are initially diagnosed too. But keep in mind that there is no one size fits all and it’s a matter of finding the root causes for each person.

We are moving in the right direction and there is hope but…

We are moving in this direction, awareness is growing and there is hope. But I know we can get there sooner.

What Dr. Markx and his colleagues have discovered and shared with the world will hopefully help us get there much more quickly.

(You can read the whole story here and a similar transformation experienced by Devine Cruz.)

I’m thrilled for April and Devine and their families, and appreciate them sharing these stories with the world. Let’s hope their stories do change psychiatry!

Resources if you are new to using amino acids as supplements

If you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin and low endorphins).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

Does this heartwarming story give you hope for psychiatry?

What do you feel we should be doing to advance nutritional psychiatry even more quickly?

Can you or a family member relate to this and what did you discover in terms of testing and nutritional support/functional medicine?

Feel free to post your feedback and questions here in the comments.

Pathological Demand Avoidance (PDA) in children with autism – how much is behavioral and how much is due to low serotonin?

June 9, 2023 By Trudy Scott 14 Comments

Pathological Demand Avoidance (PDA) is a condition associated with Autism Spectrum Disorder (ASD). It is a rare behavioral phenotype of ASD that is characterized by an overwhelming or obsessional need to resist or avoid demands, which can often lead to sensory overwhelm causing meltdowns and violent outbursts.

Although children in general may often try to avoid demands, children with PDA engage in avoidant behaviors at a greater level.

The key underlying factor is the extreme levels of anxiety associated with a loss of control, which can feel like a panic attack. Because of high levels of anxiety, they will often respond with a “No” even to tasks or activities that they normally enjoy and can spend a great deal of energy trying to gain control of situations and people.

(from an Australian PDA article: What is Pathological Demand Avoidance (PDA) and how can we address it? so I changed the spelling of behavioural and characterised to be American)

This is a typical overview of PDA and the common recommendations (as outlined in the above article) are all behavioral interventions: be an active listener and build trust, depersonalize requests, provide indirect praise, use humor and so on. Many parents find these helpful but the biochemical imbalances that trigger these behaviors are being ignored and/or there is a lack of awareness. I’d like to change this so more children and teens get quick relief.

There may be many different root causes such as low serotonin, low GABA, low blood sugar, gluten sensitivities, low zinc, low vitamin B6, low vitamin D, toxins, infections, phenols, salicylates etc. Today I’m going to discuss low serotonin and my rationale for reaching this conclusion. It’s also one of the quickest root causes to confirm (more on that below).

My rationale for proposing that Pathological Demand Avoidance (PDA) in children with autism is related to low serotonin

If we take the description above, all of these symptoms are classically found when a child (or adult) has low serotonin:

Extreme levels of anxiety
Can feel like a panic attack
Overwhelm
Meltdowns and violent outbursts
Loss of control
Spending a great deal of energy trying to gain control of situations and people (i.e. controlling)
Obsessional need to resist (any kind of obsessing is common when serotonin is low)

The second reason I suspect low serotonin with PDA is the timing of these behaviors i.e. later in the day. The article mentions that “A child with PDA can be very calm, cool and compliant at school and behave much worse at home. This is not because of incompetent parenting but because they have reached their tolerance levels and need to release that suppressed anxiety.”

This may well be a factor, however low serotonin symptoms are recognized as being more severe in the afternoon/evening when serotonin levels start to decline. If these children have low serotonin then it makes sense that these symptoms would start to increase once they get home.

My third reason is that low serotonin is common in autism/autism spectrum disorder (ASD).

Low serotonin is common in autism/autism spectrum disorder (ASD)

This paper, Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism, summarizes it as follows: “The disruption of the serotonergic system is one of the most consistent observations associated with autism. Serotonin in the brain promotes prosocial behavior and correct assessment of emotional social cues.”

Their recommendations are vitamin D and tryptophan supplementation which they say “may be a simple method of increasing brain serotonin without negative side effects.”

Testing for low levels of vitamin D and supplementing accordingly is important.

Are there other low serotonin symptoms and using a trial of tryptophan to confirm

As mentioned above, low serotonin is also one of the quickest root causes to confirm. As always, regardless of the diagnosis, we assess for low serotonin by rating symptoms on a scale of 1 to 10 (with 10 being most severe) and do a trial of tryptophan (chewed or a capsule opened on to the tongue). You will have your answer very quickly because we rate improvements in symptoms in the next 5 to 30 minutes.

In addition to the above symptoms we also look for these: worry-in-your-head and ruminating type of anxiety, phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, insomnia and afternoon/evening cravings for carbs and sugar.

Lidtke is the only brand of tryptophan that I recommend simply because I see it work so well and because of quality issues with tryptophan in the past. Here are the Lidtke tryptophan products I recommend:

Lidtke Chewable Tryptophan 100 mg is a good for doing a trial and works when lower doses are needed as with children.
Lidtke Tryptophan 500 mg can be used for doing a trial. I open the capsule and use 100mg for a child. Going forward this product is helpful when higher doses are needed, especially at night. When opened it doesn’t taste very good but can be mixed with inositol or even glutamine powder or mashed banana.

You can read more on this blog: Tryptophan for the worry-in-your-head and ruminating type of anxiety, see the full list of low serotonin symptoms here and find the tryptophan products on the supplements blog here.

If you’re new to PDA, the DSM and low serotonin/other biochemical factors

Professor Elizabeth Newson was a developmental psychologist known for her work with children in the autism spectrum. This is her 2003 paper on the topic – Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders

It’s not part of the DSM-5, the standard classification of mental disorders used by mental health professionals in the United States. This article, A Brief History of Pathological Demand Avoidance, offers a good backstory and shares why families want it to be part of the DSM.

Whether or not it becomes a distinct condition or autism subtype in the DSM, I’d like to see low serotonin (and likely low vitamin D) being recognized as one root cause. And acknowledging that there may be many other biochemical/nutritional approaches that should also be explored.

These symptoms are listed in the above article, in addition to avoidance behaviors, and all could fall into typical low serotonin symptoms:

verbal and physical aggression when feeling loss of control
self-injurious behavior
property destruction
refusal to participate in self-care such as bathing or brushing teeth (is this depression?)
inability to attend social events (is this fear and social anxiety?)
controlling what noises are allowed in a home, such as no music, or only certain music
inability to allow parents to have friends visit the home (is this also controlling?)
are often combative with siblings
issues with food, what to eat, when to eat, who to eat with
conflict with siblings

As mentioned above we also look into low GABA and low blood sugar (trials of GABA and glutamine will give quick confirmation too), gluten sensitivity, low zinc, low vitamin B6, toxins, infections, phenols, salicylates and so on. Of course, Nutritional and Dietary Intervention for Autism Spectrum Disorder is crucial.

Some success stories and connecting the dots with low serotonin

These two success stories illustrate how successful tryptophan and GABA can be and also how quickly they offer relief:

This blog post illustrates similar low serotonin symptoms and end-of-the-day timing in adults with Alzheimer’s – Sundowning in Alzheimer’s and dementia: melatonin/tryptophan for the agitation, restlessness, anxiety, disturbed sleep and aggression. It’s low serotonin that is the cause, regardless of the diagnosis.

This blog illustrates another mechanism for these types of disruptive behaviors: Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms? There is a serotonin connection when there are phenol issues too.

Resources if you are new to using amino acids as supplements

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), if you need serotonin support, the Serotonin QuickStart Program is a good place to start. This is a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening. We take a deep dive into product options including Lidtke products and others if you’re not able to access Lidtke.

If you also have low GABA symptoms, the next step to get help is the GABA QuickStart Program.This is also a paid online/virtual group program where you get my guidance and community support. Another option is the budget-friendly GABA QuickStart Homestudy program.

Now I’d like to hear from you

Have you been told your child may have Pathological Demand Avoidance (PDA)? Have you only been offered behavioral change tools and how have they helped?

Has low serotonin (and other biochemistry imbalances) been discussed too?

What symptoms does your child have and are things worse later in the day?

Has tryptophan helped reduce the above low serotonin symptoms in your child? How much helps and how quickly?

Or do you find 5-HTP works better? If yes, how much helps and how quickly?

What other biochemical changes have helped?

If you’re a practitioner, are you hearing about increased discussion of Pathological Demand Avoidance (PDA) and do you address low serotonin with your clients/patients?

Feel free to post your feedback and questions here in the comments.

Half a crushed GABA Calm for my autistic child: sleep, anxiety and sensorimotor skills (writing, horse riding and swimming) improve

January 6, 2023 By Trudy Scott 28 Comments

The inhibitory neurotransmitter GABA (gamma-aminobutyric acid) and the main excitatory neurotransmitter glutamate released by neurons in the cerebellum play an important role in sensory processing in autism. Research shows GABA to be low and glutamate to be elevated in autism spectrum disorders. While we don’t have any research supporting the amino acid GABA (used as a supplement) to raise GABA levels (and counter high glutamate levels) in autism, we do have much clinical evidence i.e. GABA can have a major impact on sensorimotor skills, as well as improving sleep, anxiety and social interaction. Today I’m sharing feedback from a mom whose autistic child is experiencing these benefits. Here is Vic’s feedback in her own words:

I use half a GABA tablet crushed in liquid for my autistic child (the Source Naturals you recommend) and it definitely helps. A whole GABA tablet and we see increased waking in the night but half seems perfect.

I’m using GABA in combination with 5-HTP. GABA was added after 5-HTP because it didn’t feel enough on its own and sleep and anxiety definitely improved at that point. We tried L–tryptophan first without success.

Sleep and sensorimotor skills have improved since weaning off an SSRI and onto the above combination as her willingness to engage with social interaction. We are also working on OT (occupational therapy) and retained reflexes and so improvements may be from that too.

Oh also supplementing b6, but not zinc as she refused it due to taste (which from reading means she probably doesn’t need it)

On a personal note there’s no way I’d manage to get her to drink [GABA Oolong] tea with her taste sensitivities – same reason I’m crushing rather than sublingual so practically speaking Source Naturals GABA is much easier than copying what they did in the study.

Vic is referring to the GABA Oolong tea study – GABA Oolong tea in children with autism: improvements in sensorimotor skills, autism profiles, anxiety and sleep (new research).

This very small (nine children) recent study found “significant improvement in manual dexterity and some large individual improvements in balance, sensory responsivity, DSM-5 criteria and cortisol levels with GABA tea.” They ingested the equivalent of 39.2 mg GABA for the day.

Sensorimotor skills that have improved: pen and pencil use, horse riding and swimming

I was thrilled to see her wonderful feedback in the comments section of the above blog and shared my delight, asking her which sensorimotor skills have improved. Vic shared this:

Sensorimotor wise, the biggest improvement I’ve noticed is her pen and pencil use – she’s actually being able to write and draw what she wants better than she was and she’s less avoidant of it in general. Her hand/eye referencing is noticeably better and her pressure control with a writing implement.

Her balance and core strength is improving (OT feel core strength generally doesn’t come properly until those internal senses are functioning) – her horse riding instructor commented on the change in how she is able to hold herself on a horse – especially when the horse got an unexpected itch the other week and she could simply adjust her body without conscious effort. Before she would have wobbled if a horse had done that.

She’s now teaching herself to swim as she has a better sense of body awareness to coordinate her limbs to all be doing what she wants.

So yeah mostly vestibular, proprioception and interoception are all working better!

As you’ll read below, research does show that GABA plays a role in sensorimotor difficulties in autism.

Some of my feedback on the GABA product and dosing, and adding it after 5-HTP

In case you’re not familiar with the Source Naturals GABA Calm product, it’s a sublingual tablet that contains 125 mg GABA (and some other ingredients). It’s typically used as a sublingual i.e. held in the mouth and dissolved, but this mom has figured out that crushing it and mixing it in liquid works best for her daughter.

To see these results with only 62 mg GABA is impressive. But as I’ve shared before, dosage does depend on your unique needs and there can be a large variation in dosing. As mentioned above, in the GABA Oolong autism study, the equivalent of 39.2 mg GABA was used daily.

That said, I did say I’d consider exploring a GABA only product at night if there are still some low GABA symptoms that remain. This could also be mixed in water.

Given that her daughter is doing occupational therapy too and also using 5-HTP and vitamin B6 (since low serotonin and pyroluria/social anxiety is common in autism) it can be challenging to tease out how much has improved with GABA alone. Vic did add GABA after having started 5-HTP and this is the best way to know what is helping which symptoms i.e. using a layered approach.

It’s also good that she figured out 5-HTP was beneficial when tryptophan wasn’t. It’s not unusual that some folks do better on one vs the other.

GABA does play a role sensorimotor difficulties in autism – the research

As reported in this 2016 paper, The Role of Sensorimotor Difficulties in Autism Spectrum Conditions:

In addition to difficulties in social communication, current diagnostic criteria for autism spectrum conditions also incorporate sensorimotor difficulties, repetitive motor movements, and atypical reactivity to sensory input.

GABA does play a role in sensorimotor difficulties as reported in this same paper. Here are some of the highlights:

The inhibitory neurotransmitter GABA (gamma-aminobutyric acid) and the main excitatory neurotransmitter glutamate released by [neurons in the cerebellum] play an important role in sensory discrimination in autism. GABA is known to decrease the firing of neurons , thereby reducing and inhibiting sensory feedback.
GABAergic functioning has been implicated in tactile reactivity.
Reductions in GABAergic system have been discovered in brain tissue: with significant reductions in GABA_A receptors, 63% reduction in comparison to controls, and a reduction by 61% of the glutamic acid decarboxylase protein (the enzyme responsible for converting glutamate into GABA).
Increased glutamate levels (excitatory neurotransmitter) in blood and platelets have been found in autism subjects, suggesting impaired conversion of glutamate to GABA, consequently increasing the excitatory state of the brain.

In the section on future directions, the authors conclude that addressing the deficiency of the inhibitory neurotransmitter GABA in the cerebellum of those with autism, “could have a global impact on sensorimotor planning, cognitive and social development.” They recommend a non-evasive GABA substitute such as oolong tea.

Elsewhere in the paper, they mention the amino acid l-theanine which “blocks the binding of l-glutamic acid to glutamate receptors in the brain, thereby perhaps aiding the improvement in motor activity by increasing inhibition of movement.”

I’d like to propose that the amino acid GABA is the subject of future research, given what we see clinically.

Resources if you are new to using amino acids as supplements

If you are new to using GABA or any of the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

Another option is the budget-friendly GABA QuickStart Homestudy program.

If you also need serotonin support, the Serotonin QuickStart Program is a good place to get help. This is also a paid online/virtual group program where you get my guidance on using tryptophan and 5-HTP safely, and community support during 5 LIVE Q&A calls. You can sign up to be notified when the next live launch of this program is happening.

Wrapping up and your feedback

I’m so happy for this young girl and she and her family must be thrilled with her results. I really do appreciate Vic for sharing this outcome – it’s so inspiring and also motivating if you are a parent.

Have you used the amino acid GABA personally or with clients/patients and observed improvements in sensorimotor skills? How much and what benefits have you seen? Which product have you used? Please do share if the diagnosis is autism spectrum disorder or something else.

Have you also seen improvements with anxiety, sleep and social skills when using the amino acid GABA?

Feel free to post your questions and feedback in the comments below.

GABA Oolong tea in children with autism: improvements in sensorimotor skills, autism profiles, anxiety and sleep (new research)

December 2, 2022 By Trudy Scott 14 Comments

A small feasibility study, A double-blind, placebo-controlled, randomised-designed GABA tea study in children diagnosed with autism spectrum conditions, explored the effect of drinking GABA Oolong tea on sensorimotor skills, autism profiles, anxieties and sleep of children with autism.

It was a very small study with nine children (5 male and 4 female) but the results were very promising… “significant improvement in manual dexterity and some large individual improvements in balance, sensory responsivity, DSM-5 criteria and cortisol levels with GABA tea.”

In addition to reducing anxiety (in all but one participant – more on that below), the paper lists the following additional information related to sensory issues, cortisol levels and sleep:

Results also demonstrated that sensory responsivity improved in two-thirds of the participants and autism symptomology decreased in over half, with four of these individuals being positively re-classified on the DSM-5 scale
Differences between evening and morning cortisol levels, deemed the ‘carryover’ effect and cortisol awakening levels were also decreased in over two thirds of the participants, which we attribute to a reduction in stress response which may have helped to reduce sensorimotor responsivity in individuals with autism.
Contrary to our hypotheses, GABA Oolong tea did not appear to impact sleep, with no discernible differences noted in a range of sleep parameters compared with the placebo, despite parents’ subjective reports that their children appeared to sleep more deeply.

They conclude as follows … “These results suggest that sensorimotor abilities, anxiety levels and DSM-5 symptomology of children with autism can benefit from the administration of GABA in the form of Oolong tea.”

What is GABA Oolong tea?

When I shared this study and results on Facebook, I had a few people ask if they could simply add the amino acid GABA to their Oolong tea: “Is it just brewed tea with GABA powder added? Or does someone make a specific tea? I can totally add some GABA to my daily tea.”

It’s not regular oolong tea with GABA added, instead it’s specially fermented to increase GABA levels naturally. Amber GABA Oolong tea by Meileaf is the actual tea used in the study and they share this on the product page.

The farmers achieve this by alternating the leaves between air and a nitrogen rich environment (with no air) during the oxidation phase. This is done over a matter of hours and naturally increases the GABA levels in the tea leaves.

They also share this: “In order to be called GABA tea, the leaves must contain at least 150 mg of GABA per 100g (normal oolong has about 6 mg so that is 25 times higher).”

GABA Oolong tea does also contain theanine, caffeine and epigallocatechin gallate. There is a large part of the study dedicated to theanine so feel free to read that at your leisure.

How much GABA was ingested by study participants?

It was a surprisingly low dose of GABA! They were given 4 cups a day of the GABA Oolong tea and this provided a total of 39.2mg GABA for the day. The authors share this about the amount of daily GABA the study participants received:

With the GABA Oolong tea the dose would be approximately 280 mg per 100 g tea. Based on using 3.5 g per tea portion this equates to 9.8 mg of GABA; multiplied by 4 throughout the day, being 39.2 mg of GABA.

I’ve reached out to confirm which tea was used in the study since Meileaf mentions that this tea contains 205 mg of GABA per 100 g whereas the study states there was 280 mg GABA per 100 g tea. I see consistency with assessing GABA levels accurately being a possible issue (more on that below).

One of the first questions I had was how could such a small amount – 39.2 mg GABA for the day – be so effective? I typically have clients start with 125 mg GABA and they may end up using this dose 3 or 4 x day (so 375 to 500 mg GABA total for the day.)

That said, we are all unique and as I’ve shared, there can be an extremely large variation in dosing. In this blog I share how Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA and yet Christina’s agoraphobic client was able to leave the house with 3000 mg GABA.

My other questions: the placebo, caffeine, a histamine reaction, low cortisol and B1 depletion

With new research there are always many factors to consider and I have a number of other questions I’d love to see addressed:

Why did the placebo tea also contain GABA? It had 22.2 mg per day of GABA – about half that found in the GABA Oolong tea.
GABA Oolong tea does contain small amounts of caffeine and how would this affect susceptible individuals? One child was more anxious – was it due to caffeine or was it too much GABA for his needs or a histamine reaction due to the fermentation process (or something else)?
Do we need to be concerned about long term use and depletion of vitamin B1/thiamine which happens with regular tea.
And what about the effects if someone already has low cortisol levels?
Will there be standard levels and accurate measures of GABA in the various GABA Oolong teas that we can rely on? This applies to consumers and practitioners wanting to try this approach and for ongoing research.
How much of the effect was also due to addressing dehydration and helping with dietary oxalate issues which are known to be common in autism?

Hopefully new ongoing research with more participants will shed light on some of these questions.

I’d also love to see head to head research comparing GABA Oolong tea with supplementation of the amino acid GABA, and a study where both are used for possible synergistic effects.

I do appreciate that the authors attempt to address the GABA blood brain barrier (BBB) debate and how GABA could work, focusing on a permeable blood brain barrier in epilepsy and increased epilepsy in autism. This angle is new to me. I’ve addressed the leaky BBB at length here in my interview with Dr. Kharrazian (it’s a theory) and one of my interviews on a prior Anxiety Summit (there are many possible mechanisms and the peripheral effects).

If you’re new to symptoms of low GABA (and cases highlighting the calming effects of the amino acid GABA used as as a supplement)

GABA (gamma aminobutyric acid) is a calming neurotransmitter and the calming amino acid GABA used as a supplement can raise GABA levels. With low GABA levels you’ll feel a physical-tension and stiff-and-tense-muscles type of anxiety.

The other symptoms we see with low GABA are panic attacks, physical tension in certain settings like public speaking or driving, and the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. Insomnia can also be due to low GABA and you’ll experience physical tension (rather than the ruminating thoughts which is the low serotonin type of insomnia – although it’s not uncommon to experience both). GABA also helps with muscle spasms and pain relief when muscles are tight.

Here are are some case studies where you can read about the calming effects (and other benefits) of the amino acid GABA used as as a supplement:

Resources if you are new to using GABA and other amino acids as supplements

Have you used GABA Oolong tea with clients/patients or personally? How much and what benefits have you seen? Which product have you used?

If you’ve also used the amino acid GABA sublingually and with success, I’d love to hear how much (and which product) and how it compares with GABA Oolong tea for anxiety, insomnia, sensorimotor skills and/or autism symptoms (as applicable to you, your child or other family member and/or your client/patient)?

If you have questions please share them here too.

Christmas tree phenols as a trigger for anger, meltdowns, anxiety, hyperactivity, insomnia, aggression, self-injury and autistic symptoms?

December 18, 2020 By Trudy Scott 16 Comments

Are you aware that the aromatic oils that give pine trees their wonderful smell are phenols and that these phenols may be a trigger for anger and meltdowns, anxiety, hyperactivity, irritability insomnia, self-injurious behavior, digestive issues and autistic symptoms (such as stimming, swinging and hand-flapping)? All this can be caused by an indoor Christmas tree in susceptible individuals.

My colleague Julie Matthews writes about this here: Avoiding Holiday Havoc: Healthy solutions to avoid meltdowns and keep the holidays happy

“When phenols are not able to be broken-down and detoxified by a process called sulfation, which is low in many children with autism and ADHD”, they can cause these symptoms and also red cheeks and ears. She shares that “phenolic compounds come in many forms including artificial petroleum-based food additives, and salicylates (a type of phenol) found in plants and foods like strawberries and spices, as well as pine trees.”

In the above blog, Julie shares this story about a client with a 10-year old son with autism. He severely regressed during the holidays and it was because of the Christmas tree. This is what the mom shared:

During the Holidays our son regressed severely. He became anxious, aggressive, and self-abusive. He cried and had tantrums regularly throughout the day. He couldn’t sleep anymore and was up for hours at a time, night after night. He was hand-flapping like crazy. We have a swing in the house for him and he now wanted to swing all day long, constantly, and do nothing else. He lost eye contact and he stopped responding to his name.

Once the Christmas tree was removed the improvements were dramatic:

The next day, he was much calmer. He seemed to have “exhaled.” Within 48 hours, our son was completely back to normal.

I shared Julie’s blog on my Facebook page and a father in my community shared a similar experience about his autistic son’s severe reactions to phenols:

Yes! My autistic son who is sensitive to phenols, would completely meltdown during the holidays. We thought it was just the change in routine and his environment, but quite by accident we discovered fragrances seemed to make him worse. We got rid of the fragrances and holiday tree/decor and the improvement in our son was dramatic! We now realize it was the phenols.

My son’s reaction to phenols/fragrances are bright red cheeks/ears, dark under eye circles, headaches, inappropriate manic laughter, aggression/self injurious behavior, marathon meltdowns/screaming, incontinence, insomnia/less than 3 hrs sleep a night, bumpy rashes, GI issues/diarrhea, excessive sensory stimming (hand flapping, lip licking, running around and body slamming into things.) During the holidays, the intensity of these reactions shot through the roof.

They found out by chance that it was the Christmas tree that was causing his son’s issues each year. It started when he was a toddler and they figured it was the stress and changes of the holidays that was the issue. One year they didn’t put up a tree and they could not believe the difference. It was then they made the connection and learned more about phenols and made the necessary changes.

By reducing phenols in his diet and environment, and giving him Epsom Salt baths and enzymes (No-Fenol), most of the above symptoms were significantly reduced.

I suspect there are many families who are seeing similar meltdowns and have no idea it could be the Christmas tree. Keep in mind that the reactions may not be as severe as these two cases I’ve shared here. If you are seeing any increase in anxiety, irritability, sleep problems, digestive issues or other unusual behavior changes in your child, keep an open mind that it may be more than just the holiday changes.

Julie’s advice is this:

Since so many children with autism and ADHD react to salicylates/phenols – in her nutrition practice she finds an overwhelming majority react negatively – she suggests a cautious approach to holiday decorating for all families of a child with autism or ADHD. Simply avoid the pine Christmas tree.
If you are unsure about their sensitivity to salicylates/phenols you might ask yourself if your child is often hyper, irritable, or has red cheeks, and other common salicylate symptoms, or whether they crave salicylate-rich foods such as berries, grapes, apples, and ketchup. If so, explore salicylates further.

I encourage you to read Julie’s blog to gain a better understanding of salicylates and phenols. If you are a practitioner and want to learn more about low salicylates/phenols and other special diets her practitioner training is excellent.

I appreciate this mom and dad for sharing their experiences with their sons so we can all learn and help other families. I also so appreciate Julie’s expertise in this area and really look forward to digging further into the research and picking her brain so I can share more.

Could your holiday anxiety and/or insomnia be phenol issues too?

Julie works with children with autism and ADHD but as someone who works primarily with adults with anxiety, I’m going to be exploring sensitivity to salicylates/phenols further. Julie recently shared this with me: “if you start looking you’ll probably see a lot of your clients with anxiety have phenol issues.”

If you also notice any increase in anxiety, anger, irritability, sleep problems, digestive issues or other unusual behavior changes, keep an open mind that it may be more than just the holiday stress or winter blues/winter anxiety. It may well be phenol issues too.

Serotonin connection to phenol issues

I’ll be blogging more about this and the fascinating serotonin connection to phenol issues. You may have noticed that many of the symptoms these 2 boys experienced sound a lot like either low serotonin or high serotonin (both of which can occur in autism). Serotonin is an endogenous phenol compound and this phenol issue is likely causing high serotonin.

When I asked Julie about this she shared this with me: “Yes, serotonin and dopamine are phenolic. And sulfation is important for the inactivation of dopamine and serotonin. So poor sulfation can lead to neurotransmitter imbalances.”

Using collagen to lower high serotonin?

I’ve blogged about how collagen can lower serotonin in susceptible folks and increase anxiety. It is also used by some folks to lower their high serotonin and make them calm. Misty reports using collagen ‘therapeutically’:

I use it to reduce tryptophan because I have a tendency toward high serotonin. I have suffered my entire life with ADD, tics as a child, grinding teeth, general anxiety, lack of motivation and later, IBS. In my 53 years I’ve never been as calm as I am now.

I don’t know if Misty has a phenol issue but I’m going to be exploring if collagen or gelatin could possibly be used to help lower the high serotonin and ease some of these severe phenol reactions quickly, in conjunction with other approaches like avoiding the foods and environmental exposures, enzymes and other nutrients, and Epsom salt baths.

Christmas tree syndrome, mold issues and toxic plastic trees

I hate to spoil the Christmas fun but here are a few other things to consider:

Christmas tree syndrome is also a real issue for many individuals
My friend and Enviornmental Toxins expert Lara Adler shares how mold from a real tree made her and her cat really sick “Within a few days of getting the tree, I broke out in a full-body rash that required a 10-day run of prednisone. I didn’t think it was the tree at first (it could have been something else), but then my cat, who was already dealing with GI inflammation and a gut issue developed asthma! Out of nowhere! She also ended up on prednisone. I got rid of the tree and both our symptoms never came back.”
She also shares some issues with plastic trees: they are often made from toxic PVC (polyvinyl chloride) with “softeners like lead and/or phthalates”, and often treated with endocrine-disrupting flame retardant chemicals. More about this on Lara’s blog here.

Have you observed a salicylate/phenol reaction with your child or client/patient? What about a less severe reaction with your child or with you personally?

Have the following helped you: avoiding the foods and environmental exposures like a Christmas tree, using enzymes like No-Fenol and other nutrients, and Epsom salt baths? In the midst of a very severe reaction has collagen or gelatin helped reduce symptoms quickly?

What about mold issues or allergies with a Christmas tree?

Feel free to post your questions here on the blog too.