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Making a decision on whether to explore medications for your child with autism is a difficult one. Most medications have not been tested on children. It’s really a roulette — one medication may work for one child and not another. Because individuals with autism spectrum disorder have brains that are wired differently than that of neurotypical peers, medications affect them differently. Whether or not you decide to use medications is your personal decision. Talk to your physician, talk to other parents, and most of all, educate yourself before you venture down the medication road. The information below is not to be construed as medical advice, but merely informational in content. Always consult a physician before attempting any medications, both over the counter and prescription. Just remember, there is no cure for autism, so don’t expect too much. Medications treat the symptoms, not the root of the disorder. Temple Grandin once said that a medication should have a “WOW” effect. If you don’t notice a dramatic difference — enough to make you say “WOW” — it may not be the medication for you or your child.

Anti psychotics Used in Autism:

Neuroleptic medications, also known as anti psychotics, are used to treat a wide variety of serious mental illnesses. Most of the anti psychotic medications affect dopamine production or absorption, but some also act on serotonin or other transmitters. The two groups of anti psychotics are Conventional anti psychotics and Atypical anti psychotics

Atypical Anti psychotics include Risperdal (risperidone), Seroquel (quetiapine), Zyprexa (olanzapine), Zeldox (ziprasidone), Clozaril (clozapine), and Abilify (aripiprazole).

SRI’s (Selective Seratonin Reuptake Inhibitors)/Antidepressant Use in Autism

Medication may be used in autism to treat attention issues, anxiety, or overall mood. These drugs will often reduce symptoms such as perseverative behaviors, tantrums, irritability, aggressive, and social responsiveness. Antidepressants include Amitriptyline (Elavil), Bupropion (Wellbutrin), Clomipramine (Anafranil), Fluvoxamine (Luvox), Fluoxetine (Prozac), Paxil, Celexa, Lexapro, Effexor

Antidepressant Use in Autism

Autism and Treatments with SSRI Antidepressants

A list of medications and an explanation of each by

Stimulant Use in Autism

Ritalin, Adderal, Concerta, Metadate,

Use of Stimulants in Autism

Medications Used in Treatment

Medications are often used to treat behavioral problems, such as aggression, self-injurious behavior, and severe tantrums, that keep the person with ASD from functioning more effectively at home or school. The medications used are those that have been developed to treat similar symptoms in other disorders. Many of these medications are prescribed “off-label.” This means they have not been officially approved by the FDA for use in children, but the doctor prescribes the medications if he or she feels they are appropriate for your child. Further research needs to be done to ensure not only the efficacy but the safety of psychotropic agents used in the treatment of children and adolescents.

A child with ASD may not respond in the same way to medications as typically developing children. It is important that parents work with a doctor who has experience with children with autism. A child should be monitored closely while taking a medication. The doctor will prescribe the lowest dose possible to be effective. Ask the doctor about any side effects the medication may have and keep a record of how your child responds to the medication. It will be helpful to read the “patient insert” that comes with your child’s medication. Some people keep the patient inserts in a small notebook to be used as a reference. This is most useful when several medications are prescribed.

Anxiety and depression. The selective serotonin reuptake inhibitors (SSRI’s) are the medications most often prescribed for symptoms of anxiety, depression, and/or obsessive-compulsive disorder (OCD). Only one of the SSRI’s, fluoxetine, (Prozac®) has been approved by the FDA for both OCD and depression in children age 7 and older. Three that have been approved for OCD are fluvoxamine (Luvox®), age 8 and older; sertraline (Zoloft®), age 6 and older; and clomipramine (Anafranil®), age 10 and older.4 Treatment with these medications can be associated with decreased frequency of repetitive, ritualistic behavior and improvements in eye contact and social contacts. The FDA is studying and analyzing data to better understand how to use the SSRI’s safely, effectively, and at the lowest dose possible.

Behavioral problems. Anti psychotic medications have been used to treat severe behavioral problems. These medications work by reducing the activity in the brain of the neurotransmitter dopamine. Among the older, typical anti psychotics, such as haloperidol (Haldol®), thioridazine, fluphenazine, and chlorpromazine, haloperidol was found in more than one study to be more effective than a placebo in treating serious behavioral problems.25 However, haloperidol, while helpful for reducing symptoms of aggression, can also have adverse side effects, such as sedation, muscle stiffness, and abnormal movements.

Placebo-controlled studies of the newer “atypical” anti psychotics are being conducted on children with autism. The first such study, conducted by the NIMH-supported Research Units on Pediatric Psychopharmacology (RUPP) Autism Network, was on risperidone (Risperdal®).26 Results of the 8-week study were reported in 2002 and showed that risperidone was effective and well tolerated for the treatment of severe behavioral problems in children with autism. The most common side effects were increased appetite, weight gain and sedation. Further long-term studies are needed to determine any long-term side effects. Other atypical anti psychotics that have been studied recently with encouraging results are olanzapine (Zyprexa®) and ziprasidone (Geodon®). Ziprasidone has not been associated with significant weight gain.

Seizures. Seizures are found in one in four persons with ASD, most often in those who have low IQ or are mute. They are treated with one or more of the anticonvulsants. These include such medications as carbamazepine (Tegretol®), lamotrigine (Lamictal®), topiramate (Topamax®), and valproic acid (Depakote®). The level of the medication in the blood should be monitored carefully and adjusted so that the least amount possible is used to be effective. Although medication usually reduces the number of seizures, it cannot always eliminate them.

Inattention and hyperactivity. Stimulant medications such as methylphenidate (Ritalin®), used safely and effectively in persons with attention deficit hyperactivity disorder, have also been prescribed for children with autism. These medications may decrease impulsivity and hyperactivity in some children, especially those higher functioning children.

Several other medications have been used to treat ASD symptoms; among them are other antidepressants, naltrexone, lithium, and some of the benzodiazepines such as diazepam (Valium®) and lorazepam (Ativan®). The safety and efficacy of these medications in children with autism has not been proven. Since people may respond differently to different medications, your child’s unique history and behavior will help your doctor decide which medication might be most beneficial.