Understanding Medications for Autism Spectrum Disorders
Many children with an autism spectrum disorder (ASD) can benefit from medications, but unfortunately there is a very poor understanding of overall medication use for these kids, says Paul T. Shattuck PhD, an assistant professor with the Brown School at Washington University.
As of now, there are not any drugs that will help with the core symptoms of autism, including social withdrawal. Medications are often used to treat behavioral problems, such as aggression, self-injuring behaviors, and severe tantrums that keep them from functioning more effectively at school or home.
Most often, the medications have been officially approved by the US FDA for another disorder, but are prescribed for children with autism “off-label.” Children with co-morbid conditions, such as anxiety or depression, epilepsy, or ADHD are prescribed additional medications to treat those symptoms.
The first medication approved for behaviors in children and adolescents with autism was Risperdal (risperidone) in October of 2006. This drug treats irritability, aggression, sudden mood changes, and self-injurious behaviors. The drug is also approved for use in schizophrenia and bipolar disorder. Risperidone is an antipsychotic which works by changing the activity of certain natural brain chemicals. Side effects of the drug include drowsiness, dizziness, nausea, constipation, increased appetite and weight gain, difficulty falling or staying asleep, or (unfortunately) agitation.
What Risperdal cannot do, however, is improve conversational ability or social skills in autistic children, nor does it appear to reduce other behavioral traits common in autism such as obsessive behavior. Drugs such as Prozac (fluoxetine) or Zoloft (sertraline) may be prescribed for obsessive-compulsive disorders.
Other antipsychotics, such as Zyprexa (olanzapine) may also be prescribed for the treatment of aggression; however these are not specifically approved for children with autism.
Anxiety and Depression
Selective serotonin reuptake inhibitors (SSRIs) are most often prescribed for symptoms of anxiety and depression. In children, the approved drugs include Prozac (fluoxetine), Luvox (fluvoxamine), and Zoloft (sertraline). Parents should note that there is an increased risk of suicidal thoughts or behavior (suicidality) in children and adolescents treated with SSRI antidepressants. But recently, studies have shown that more often than not, the benefits of these drugs outweigh the risks to children with major depression and anxiety disorders.
For example, one study found that 60% of patients with autism became less distraught and aggressive when on Prozac (fluoxetine). They were also calmer and better able to handle changes in their routine or environment.
For more information, an excellent resource is the National Institute of Mental Health’s “Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers.”
Epileptic seizures are common among children with autism, occurring in one in four. Seizures are treated with anticonvulsant medications such as Tegretol (carbamazepine), Lamictal (lamotrigine), Topamax (topiramate), and Depakote (valproic acid). Keep in mind, though, that anticonvulsant medications usually reduce the number of seizures that occur, but cannot always eliminate them.
Inattention and Hyperactivity