Medications

No medication can correct the brain structures or impaired nerve connections that seem to underlie autism. Scientists have found, however, that drugs to treat other disorders with similar symptoms are sometimes effective in treating the symptoms and behaviors that make it hard to function at home, school, or work. 

The decision to medicate or not medicate your child is upto the parents and it is a hard decision to make. However for many children, a medication can make the world better for the child and the child better for the world.

1. Stimulants

Some children with autism experience hyperactivity, the frenzied activity that is seen in ADHD. The drugs seem to be most effective when given to higher-functioning children with autism who do not have seizures or other neurological problems.

2. Anti-depressants: Used to treat either stereotypical or self-injurious behaviors. Called Selective Serotonin Reuptake Inhibitors or SSRI's. However there has been very little research that to show how these meds work - it is more anecdotal evidence. 

3. Anti-hypertensive (high blood pressure): Used to treat aggressive behaviors. 

4. Anti-psychotics: - used to treat aggressive behaviors

5. Anti-epileptics: Help control aggressive behaviors by stabilizing brain activity.  Requires regular blood testing in order to insure that liver or brain marrow damage does not occur. Since these are designed to treat seizures, they are often given to autistics who have seizures, and their use provides the additional benefit of behavioral management. 

6. Opioid Antagonist: Used to treat self-Injurious Behaviors: Research has shown that chemically, the body releases naturally occurring endorphines when a self-injurious behavior occurs, much as some narcotics do to cause addiction. This discovery led researchers to wonder if the repeated self-injurious behaviors might be a response to an addition to the body's own endorphin release. If this were true, then medications designed to neutralize the effects of some narcotic substances, opioid antagonists, might be useful in treating this pattern in the Autistic/PDD individual as well.

6. Other drugs under clinical study currently

Valproate: This study will examine the effect of valproate, a medication used to treat seizures and bipolar disorder, on aggressive behavior in children and adolescents with autism. http://clinicaltrials.gov/ct/show/NCT00065884

Donepezil HCl (Aricept): A recent study found that donepezil HCl helped to improve speech production, attention span, and ability to express emotions in a group of children with autism. This study will provide an opportunity to conduct further testing of the effects of donepezil HCl on the cognitive deficits presumed to underlie the core features of ASD. http://clinicaltrials.gov/ct/show/NCT00047697

6. Other

Obsessive-compulsive disorder (OCD), like people with autism, are plagued by repetitive actions they can't control. Based on the premise that the two disorders may be related, one NIMH research study found that clomipramine, a medication used to treat OCD, does appear to be effective in reducing obsessive, repetitive behavior in some people with autism. Children with autism who were given the medication also seemed less withdrawn, angry, and anxious. But more research needs to be done to see if the findings of this study can be repeated.

Because many children with autism have sensory disturbances and often seem impervious to pain, scientists are also looking for medications that increase or decrease the transmission of physical sensations. Endorphins are natural painkillers produced by the body. But in certain people with autism, the endorphins seem to go too far in suppressing feeling. Scientists are exploring substances that block the effects of endorphins, to see if they can bring the sense of touch to a more normal range. Such drugs may be helpful to children who experience too little sensation. And once they can sense pain, such children could be less likely to bite themselves, bang their heads, or hurt themselves in other ways.

Chlorpromazine, theoridazine, and haloperidol

Although these powerful drugs are typically used to treat adults with severe psychiatric disorders, they are sometimes given to people with autism to temporarily reduce agitation, aggression, and repetitive behaviors. However, since major tranquilizers are powerful medications that can produce serious and sometimes permanent side effects, they should be prescribed and used with extreme caution.

Abilify

It is intended for use to reduce the symptoms of schizophrenia Not tested or studied for children under 18 Can cause TD and NMS Here's the full gen from the FDA: http://www.fda.gov/cder/consumerinfo/druginfo/abilify.htm

Brand Name: Abilify Active Ingredient: aripiprazole Strength(s): 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg Dosage Form(s): Tablet Company Name: Otsuka Pharmaceutical Co., Ltd; Bristol Myers Squibb Co. Availability: Prescription only *Dated Approved by FDA: November 15, 2002 *Approval by FDA does not mean that the drug is available for consumers at this time. What is Abilify used for? Abilify is used to treat schizophrenia. Abilify has not been studied in children under 18 years of age. Who should not take Abilify? Do not take Abilify if you are allergic to aripiprazole or any of the other ingredients in Abilify. General Precautions with Abilify: Abilify may impair judgement, thinking, or motor skills. You should be careful in operating machinery, including automobiles, until you know how Abilify affects you. Abilify may cause trouble swallowing (esophageal dysmotility). This can cause choking and lead to a type of pneumonia called aspiration pneumonia in some patients. Avoid drinking alcohol while taking Abilify. It is important to avoid overheating and dehydration while taking Abilify. Abilify may make it harder to lower your body temperature. What should I tell my health care provider? Tell your health care provider if you: have any heart problems, or have had a heart attack or stroke. have or have had seizures. Abilify can make it easier for you to have a seizure, especially if you have or have had seizures or certain medical conditions that increase the chances of having a seizure. are trying to become pregnant, are already pregnant, or are breast-feeding. Tell your health care provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your health care provider if you take: Ketoconazole Quinidine Tegretol (carbamazepine) Medicines to treat high blood pressure Some of these medicines may cause serious side effects if used while you also take Abilify. Some of these medicines may affect how Abilify works, or Abilify may affect how these medicines work. What are some possible side effects of Abilify? (This is NOT a complete list of side effects reported with Abilify. Your health care provider can discuss with you a more complete list of side effects.) Some rare but serious side effects with Abilify include: Neuroleptic Malignant Syndrome (NMS). Symptoms of NMS include high fever, muscle rigidity (tightness), confusion, change in pulse, blood pressure or heartbeat, and sweating. It can also lead to muscle breakdown and kidney failure. Tardive dyskinesia (TD). Symptoms of TD include involuntary (uncontrolled) and abnormal muscle movements. Some common side effects with Abilify include: headache weakness nausea vomiting constipation anxiety problems sleeping lightheadedness (dizziness) sleepiness restlessness rash For more detailed information about Abilify, ask your health care provider.

http://www.patientcenters.com/autism/news/med_reference.html

(good website that discusses medication)

Parent Comments

Ritalin (12/03)

At one point I wanted to try ritalin. when x was 4, x is 5 now. But my husband was on it growing up and he developed some involutary muscle movement from it and said he hated the stuff and that he was horribly addicted to it. Although I'm sure it helped him a great deal with school and other things, he is so dead set against it for our daughter . So, some dietary changes have helped and supplements ( and answers to prayer) We will just have to see how it goes in school . For now we will roll with the changes. I'm glad it has helped your kid

Ritalin (12/03)

My son is 16 with HFA and ADHD and could never have succeeded in his inclusive classroom setting without Ritalin. He's been on it since he was 5 and is almost 6 feet tall and still growing. Because he was able to attend to instruction he has done well in math, taking regular Algebra 1 this year in high school and has been in regular social studies. He still does resource for English, which is harder due to his difficulty with abstract concepts. If I ever forgot is dose I got a call by 9 AM from a teacher asking me if he was feeling well, etc due to his inability to sit still and attend in class. Every kid is different and I have known several kids autism who did great on Ritalin.

Abilify (12/03)

I have heard some very good things about this medication. My friend's son is doing quite nicely on it. The best place to probably learn about it is from a psychiatrist who is VERY well versed in autism and related disorders, or a developmental pediatrician who specializes in special needs, and has an interest in pharmacology. ( You also want to be sure this person isn't pushing drugs on parents, but is both experienced, concerned and treats you like a partner!)

Abilify (12/03)

A lot of medications that are used to treat symptoms that children with autism have, are used for other things like Chlonodine is orginally used to treat high blood pressure, however it is also being used with children with autism, some with positive effects. All the meds are that way with autism because there is not a medication for autism, like their are for treating other disabilities. My 6-year-old nephew takes Abilify and we have seen VERY good results.

Abilify /clonidine(12/03)

Since so many on the list were interested in Abilify, I wanted to update = you all. B has been taking it for several weeks now and it's true -- it's nothing short of amazing. He's had very few tantrums, he's not depressed any longer and he's talking again instead of screaming. He's happy and very sweet most of the time. He's not only his old self again -- he's even better. I have been receiving glowing reports from the school and I have not yet  informed them that he's taking anything. I really wanted to see if they saw a difference. A few examples of what I mean by better: Today B's brother was watching "The Sum of All Fears" and we didn't  have to change the channel. All B said was, "Don't watch that. It's bad." and he left the room. That was it. The old B would never tolerate violence of any sort. He would have screamed, attacked someone and/or tried to break something. The channel would have been changed -- period. B's behavior had become so bad before we tried Abilify that I really couldn't take him anywhere without a meltdown. Last weekend B rode  in a fire truck in Christmas parade with me and the new owner of the paper where I work. He said "Merry Christmas" to spectators over the loud speakers. He spoke very clearly and had the time of his life -- right there in the midst of thousands of people. When we finished the parade route, he wanted to do it again! The entire process (decorating the fire truck, getting in line, the fireworks and the parade, took several hours and there was not even a hint of a meltdown. Not even during the fireworks. Before the parade, there was a fireworks show. B would normally run as far as possible from the fireworks, screaming and crying with his ears covered. He covered his ears and laid down in the seat of the fire truck and that was it. This is MAJOR progress. B went to the ARC Christmas Party yesterday and actually played with another child. He played and ran and laughed. Then -- prepare yourself  now --- HE SAT ON SANTA'S LAP!!! Not once but twice. I guess he put  a double order). I though Santa was going to fall out of his chair when Boone asked for  "Big Mutha Truckers" -- it's playstation 2 game he's been looking up on  the internet every day. I guess I'll have to get it now. I'm definitely getting him the biggest fire truck I can find. Everybody who knows him has commented on his improvement. He's reading more than before and is more talkative than before. He is calm, but not a walking zombie at all -- in fact he's quite alert and the medication has not affected his sleep in any way. He still takes clonidine to help  him sleep. He is taking .5 milligrams Abilfy per day. I give it at the same time as the clonidine. It doesn't dissolve like clonidine, but I  crush it up mix it in with a soft drink in a shot glass. Thanks, K and all the others who gave me the courage to try this medication. It has been a lifesaver.

> Did B try any of the other atypical antipsychotics? Our results have  been poor with risperedol and seroquil.

 We have never tried none of the others. I was afraid to try, but his doctor thought this particular med seemed safer and had fewer side efects. The doctor said it wasn't as effective for schizophrenia as they had hoped, but that they'd had amazing results with autistic people.

Risperdal (12/03)

J is on Risperdal, and it's making him itch. I've been worrying about long-term effects, too. I can search it, but what do you (and everybody else here) know about the long-term effects of Abilify?  J is only nine, but he talks constantly, to himself if nobody else is around. J still won't go to parades, and fireworks are utterly out of the question, except for the ones we watch from across the Hudson. They're not right overhead, so they're not loud. I'm going to talk to J's neurologist, because Josh has been having a terrible time lately--Xmas is his season of anxiety, and he's been spinning out a lot lately, which includes hitting and liberal use of what he calls The Bad Word--that F one. And he's so nervous he follows me around, literally six inches away from me, everywhere I go. He doesn't even want to go to the bathroom alone (but he does--I'm not standing guard outside the bathroom, no matter what he says). And he got so upset that a little (rotten) kid down the block was mean that he wanted to jump in front of a car. After I finished freaking out I was deeply grateful that J can tell me what he feels and knows to come to me and tell me. But his OCD is almost completely out of control. He gets terribly nervous about snow--when is it coming, how much will there be, when will it stop? Imagine being that anxious! I'm OCD myself, so I CAN imagine, and it must be hideous for him. Schedules don't help. Social stories help, but you have to tell him everything over and over and over, because he needs to keep hearing the reassuring stuff again and again, even if he knows it's true. And it's really hard on me--after about 5 hours of having him clinging to me every second, I get annoyed, and then I hate myself for getting annoyed.

Abilify/ Risperdal (12/03)

Thank You so Much for the update on Abilify. My 12 yo C has been on it for a month now, and as of last week we are starting to slowly wean him off the resperidol. Right now I see no difference, but am waiting. He doesn't seem hurt by it, and it is deffinately better than when he is w/o an medications.

Abilify/ Risperdal (12/03)

MY nephew takes Abilify as well and we have seen excellent results as well. He has been taking it since October of this year. However, the only place we are not seeing great results is with his obsessions and his doctor said Abilify would help with this. They are just getting increasingly worse. I also work with several other children who are taking Abilify, instead of Risperdal and seeing great results. I too have seen a couple of children itching that are on Risperdal.

Risperdal (1/04)

My son has been on Risperdaal about two years. It allows him to concentrate long enough now to actually do something other than stim. He still has tantrums when frustrated, but without the meds the tantrums were pretty much constant. His attention span is still very short, but it is long enough for him to be learning in school, to play games, to actually participate in life a little bit.