Despite claims of miracle cures, there are no
medications that have been proved to be a 'cure' for Autism Spectrum Disorders to date. However, there are cases where medication can
play a role in reducing the symptoms of comorbid
disorders or behavioral
issues, particularly if these symptoms have been interfering
with the effectiveness of other interventions and schooling. Examples
of these situations include:
Seizures and epilepsy
Parents and the medical community are wise in
being very cautious to recommend medications for children while
they are still physically and cognitively developing. Parents have
pointed out that whilst a subset of children have been found to
have co-morbid mood, anxiety and compulsive disorders, autistic
people are not necessarily psychotic, particularly anxious, depressed
or have bipolar
disorder. Medications should only be used when the benefits significantly
outweigh the risks involved.
It should be noted that in some cases, parents
have found drug therapy very helpful when all other interventions
have failed to solve a particular issue. In particular, comorbid
disorders such as ADHD
disorder have often responded well to certain medications. Doctors
are generally aware of the need to minimize the amount of medication
in a child's life and parents should research this area thoroughly
before making decisions about biomedical interventions.
Although most medications undergo rigorous research
to qualify as evidence-based
treatment, their use in the context of Autism Spectrum Disorders
and/or children still requires much more research in the majority
of cases. The younger a child is, the greater the risks of using
medications for an immature nervous system so the benefits of the
drug must be very high for younger children, such as preventing
extreme self-injury when other interventions have not worked.
hyperactivity and lack of attention
The most frequently prescribed medications for
are stimulants, which work by stimulating the areas of the brain
responsible for focus, attention, and impulse control. Because many
of the medications used to treat ADHD are powerful stimulants with
a potential for abuse, there is controversy surrounding prescribing
these drugs for children and adolescents. However, research on ADHD
sufferers who either receive treatment with stimulants or go untreated
has indicated that those treated with stimulants are in fact much
less likely to abuse any substance than ADHD sufferers who are not
treated with stimulants.
Close monitoring is required for a child's response
to stimulants. One study found that a third of children on the autism spectrum actually had increased hyperactivity, dysphoria, stereotypies
or motor tics (Di Martine, Melis, & Cianchetti 2004).
seizures and epilepsy
occur in about a quarter of children with an Autism Spectrum Disorder.
There is no cure but anticonvulsant medications are the most common
treatment. Medications used include valproic acid, lamotrigine,
topiramate, and carbamazepine. The dosage of the medication is adjusted
so that the least possible amount of medication will be used to
A medication must be taken when specified to maintain
a constant level in the blood. A regular blood test is usually done
to measure the amount of drug in the blood stream. Too much may
have side effects such as dizziness or an upset stomach. Too low
and there may be a risk of seizures. Parents should keep track of
the frequency of their child's seizures and notify the doctor or
nurse of medication side effects in case the medication needs adjusting.
Medications and behavioral issues
In some cases, behavioral
management programs may be supported by medications to reduce
behavior. The medications used are those that have been developed
to treat similar symptoms in other disorders. Anti-psychotic medications
have been used for severe behavioral problems, as they reduce activity
of dopamine in the brain. Typical anti-psychotics like chlorpromazine,
haloperidol, thioridazine and fluphenazine have been tested and
found useful in managing extreme behavioral problems. However, further
research is needed in their use by children and adolescents and
there are possible side effects associated with each medication.
depression, anxiety and obsessive compulsive disorder
Selective serotonin reuptake inhibitors, or SSRI’s,
are commonly prescribed for adults with depression
disorders. In autistic children, these have been shown to lower
the rates of repetitive
behavior and increase social interaction and eye contact. However,
further research is needed in this area as the effects of some SSRIs
on young children are still not fully explored.
research on anti-psychotics
Although no medication acts a 'cure' for Autism Spectrum Disorders, typical and atypical anti-psychotics have proved
to be the most effective medication for reducing the overall symptoms
to date. Their use in not wide spread due to side-effects, particularly
with long-term use.
Typical anti-psychotics such as haloperidol, fluphenazine,
and thioridazine, were actually developed to treat schizophrenia.
They help to manage symptoms of Autism Spectrum Disorders but
possible side effects include stiffness, restlessness and involuntary
movements. Long-term use can result in permanent tardive dyskinesia
Atypical anti-psychotics include risperidone,
clozapine, ziprasidone, olanzapine and quetiapine, and were developed
to minimize the side effects of typical anti-psychotics. Research
on risperidone has been conducted with adults who have Autism, and
symptoms such as repetitive behaviors, aggression, irritability
and anxiety were reduced. No changes in language or social behaviors
were noted and side effects included drowsiness, weight gain, dizziness,
increased heart rate and blood pressure, fatigue and drooling (McCracken,
McGough & Shah 2002).
Another study found similar outcomes for ziprasodone,
quetiapine and olanzapine ((King & Bostic 2006). A study on
aripiprazole found similar to outcomes but with less chance of substantial
weight gain in children on the autism spectrum ((Stigler, Posey,
& McDougle 2004). As with most interventions for Autism Spectrum Disorders, much more research is needed to accurately establish
these medications as evidence-based
basic principles for medication as an Autism intervention
If you decide to allow medication for your child,
it can pay to not tell others. For example, a teacher may notice
an improvement in behavior without being influenced by knowledge
of the medication being used. Other interventions should not be
changed at this time, so that you can tell if changes are due to
Medications should be introduced carefully, as
the nervous system in many people with Autism is very sensitive
and only a low dose of medication may be needed. Medication trials
should always start with the lowest possible dose, with gradual
increases until its effectiveness is established. The timing of
medication is very important so parents must have a clear understanding
of when it should be taken.
It can be useful to keep a diary of your child's
response to medication, especially if several medications are prescribed.
Don't stop medications abruptly, particularly if they have been
taken for a long time. Always check with your doctor on the best
way to discontinue a prescribed medication if its benefits do not
outweigh its risks.
A 'baseline' should be set before using medication.
These means getting an accurate idea of symptoms so that you can
assess how well the medication is working e.g. how often is the
child having seizures, or violent outbursts, or how many hours sleep
each night. Where possible, this should be written down before,
during, and after using a medication trial.
A child with Autism or Asperger's syndrome may
not respond in the same way to medications as other children. Ideally
parents should work with a doctor who has experience with Autism Spectrum Disorders.
Learn about the possible side effects of the
medication and monitor your child closely for their signs.
autistic adults and medication
Many autistic adults themselves are against the
over prescription of neuroleptic drugs in autistic people to control
behavior. Others with co-morbid disorders have been relieved to
have medication to manage these problems. Some psychiatrists are
just now beginning to explore minimal doses of medication for autistic
children. People against the use of Neuroleptic medications for
people with Autism have formed an organization called Autistic People
Against Neuroleptic Abuse.
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range of Asperger's and Autism fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU
Free Documentation. It is derivative of an Autism and Asperger's
syndrome-related articles at http://en.wikipedia.org