Medication for Autism and ADHD
Parents of children who have ASD/ADHD that co-occur have reported high rates of medication usage. However, research on psychopharmacological treatments is limited in both number and type.
Risperidone (Risperdal) and aripiprazole (Abilify) are the only drugs approved by the FDA to be used in children with autism. They can help decrease aggression and irritability. Other drugs may be beneficial.
Antipsychotics
While interest in co-occurring ADHD and ASD symptoms has increased but research remains insufficient. There are inattentive adhd medication of psychosocial treatment options for each disorder. However, few studies have evaluated the effectiveness of these treatments when they are combined with other symptoms. It is important to understand the nature of the interactions between co-occurring disorders as well as how they change over time. This will inform both pharmacological as well as psychosocial approaches.
Many people who suffer from ASD also have co-occurring ADHD and other mental health issues such as anxiety or depression. These disorders are treated with a variety of psychosocial therapies, such as cognitive behavior therapy (CBT) as well as family therapy, and interpersonal therapy. These psychosocial treatments are more effective than pharmaceutical treatments for some people who have ASD/ADHD comorbidity.
For the core ASD symptoms like poor social communication skills and rigid thinking, non-pharmacological interventions are usually preferred. These include peer support groups and behavioral training. For those suffering from comorbid ADHD and ASD symptoms such as irritability, aggression, and disordered mood dysregulation medication can be helpful. However the use of atypical antipsychotics has not been proven to help improve the fundamental ASD symptoms and the evidence supporting these medications is sporadic at best.
Current hypotheses suggest symptoms of autism spectrum disorders (ASD) and ADHD are mediated through abnormalities in neurotransmitter pathways. This is particularly ones that involve glutamate, dopamine and serotonin.2 These changes affect the mesocorticolimbic prefrontal cortex which is involved in the regulation of emotions and control of behavior.
Some of these abnormalities are believed to be caused by reduced activity in certain brain regions, including the striatum. In order to treat ADHD and ASD various drugs that regulate dopamine and glutamate levels are under investigation.
A variety of types are being investigated for the treatment of the comorbid ADHD symptoms and ASD such as risperidone Aripiprazole, aripiprazole and domperidone. A consensus nomenclature is still pending for dopamine-antagonists.
Antipsychotics are no different than any other medication. The best available data on aripiprazole and risperidone in adults suffering from ASD and ADHD are based on randomized controlled trials. These trials used parallel crossover and withdrawal strategies. In general, the drugs perform better than placebo in reducing irritability and aggression and improving functioning. The drugs are generally well-tolerated. However, one-third of individuals who use these medications will discover that they are effective for all or the majority of their symptoms, while the remaining two-thirds of them will see only minor improvement.
Stimulants
Despite the fact that no medical treatment is generally suggested for autism, medication may be beneficial for some children and adults. Antipsychotics, for instance, help to ease anxiety and reduce self-injurious behavior and stimulants such as methylphenidate, which aids in the treatment of ADHD symptoms, can help improve the ability to focus. However, they don't treat the core autism-related behaviors such as repetitive and restricted interests or difficulty communicating. Many people with autism also suffer from co-occurring mental health conditions like depression, mood disorders or anxiety that affect everyday functioning.
Autism can also cause anger in adults and children. This can result in outbursts or self-injury, and difficulties with routines and transitions. Atypical antipsychotics like risperidone (Risperdal) and aripiprazole (Abilify) are the only medications approved for treating autism-related anger. These drugs are believed to work by affecting the brain's dopamine system which is involved in emotions and decision-making.
The most frequently prescribed ADHD medication is methylphenidate like Ritalin, as well as mixed amphetamine salts that increase dopamine activity in the frontal lobes of the brain. Some studies suggest that these drugs are just as effective for people with autism and ADHD as they are in those who have pure ADHD however other studies indicate that they are less beneficial. However, it is important for parents to talk with their doctor to determine whether or not the benefits outweigh potential adverse effects of these drugs.
Some researchers believe that second-line ADHD medications such as atomoxetine or guanfacine, may be more efficient in reducing ADHD symptoms among people with autism. These medications are believed to function by interfering with the dopamine-norepinephrine axis, which is associated with motivation and mood.
The psychiatrist and a behavioral therapists are trying to help him develop social skills and manage his anxiety. Even with these treatments hyperactivity and inattention can continue to hinder his development. His family decided to give him an ADHD medication to aid in his focus.
After three months he is more focused at school and in his daily activities. Parents can tell that he is more attentive, listens to what others speak and participates in group activities. His mother says that the medication has been an absolute lifesaver.
Benzodiazepines
The benzodiazepines comprise a category of drugs that slow the central nervous system, resulting in tranquility and sleep. These drugs are used to treat various conditions, such as anxiety disorders, seizures, and insomnia. They target specific receptors for the neurotransmitter GABA (gamma-aminobutyric acid), which inhibits brain waves and impedes communication between neurons. By keeping GABA receptors open longer and allowing them to be opened more frequently benzodiazepines enhance inhibition and prevent the overactivity of excitatory neurons. The theory is that typical autism behaviors are triggered by an imbalance between the excitatory and inhibitory neurons in the brain. Animal models support this hypothesis, showing that clonazepam reverses some of the autistic behaviors observed in mice suffering from Dravet syndrome, a form of epilepsy.
Anxiety is a typical co-occurring condition among people with autism spectrum disorders. In some instances, anxiety is the cause of self-injurious or aggressive behaviors. In other instances it's a reaction to sensory issues that make life difficult and trigger anxious feelings.
Treatment choices include antidepressants, which are believed to enhance self-esteem and coping abilities by increasing the levels of the chemical norepinephrine within the brain. They also decrease the reuptake of neurotransmitters such as serotonin, dopamine and norepinephrine. This helps to reduce irritability and anxiety. Atypical antipsychotics such as risperidone and aripiprazole can help people with autism with anger, irritability, or Tourette syndrome.
Melatonin can improve the quality and duration of sleep for adults with ASD. However, controlled studies are lacking in this population. Methylphenidate is effective in treating ADHD symptoms in children suffering from ASD however it's not as effective as it is in typical children.
The medications for autism and ADHD can be dangerous when not used correctly. It is important to consult with your physician to find the right medication and dosage for your child or teenager. Always follow the directions on the medication label. Don't discontinue or start taking your medication suddenly, as this can be extremely dangerous. If you suspect that you or someone you know has taken too much, seek medical attention immediately. Note your child's weight and height on a regular basis as well as their menstrual cycle to make sure the medication isn't causing unwanted side effects.
Medication Options
Many kids with autism also have ADHD and it's not uncommon for these conditions to coexist. Both disorders are typically treated with medications. The drugs that are commonly used for ADHD -the methylphenidate (Ritalin) amphetamines (Adderall, Vyvanse), atomoxetine (Strattera) and Guanfacine (Intuniv, Tenex) -- can be effective in treating the hyperactivity and impulsivity associated with autism.
In addition, some children with autism are prone to extreme irritability and aggression and these symptoms can be difficult to control with behavior strategies on their own. Medications like Abilify and Risperdal can help reduce aggressiveness and self-injury through the neurotransmitter dopamine. These drugs have not been approved by the FDA to be used with children with autism. However, they are sometimes prescribed 'off-label' for specific symptoms.
It is crucial parents talk to their pediatricians if the medication is suitable for their child. Many studies have proven that children who are taking ADHD medication to treat Autism can have better quality of life both at home and in school, and can make significant progress in academics and behavior.
Psychiatrists have been trained to help children with the symptoms of ADHD and autism. They can suggest behavior-based parent training that involves manuals and group-based courses that teach parents how to manage disruptive behavior. They can also provide psychosocial services which focus on improving communication and relationships between the family members.
Some families, however, opt to use medication to control their child's behavior. Some parents have discovered that the calming effects of antipsychotics can help reduce their child's irritability, aggression and self-injury, and may be willing to consider this option if other treatments do not work.
Similarly the majority of children who suffer from autism also have mental health issues that hinders their ability to learn and function, like depression or anxiety. These conditions are often co-occurring and can affect therapy effectiveness. For these children using a combination of cognitive behavioral therapy and medication can be beneficial. This method is especially beneficial for kids who have a more severe autism disorder or who do not respond to other interventions.