Drugs and Medications for Autism Symptoms

You've read that there's no known medical cure for autism, yet your doctor is prescribing medication. What's that about? The answer is simple. Your doctor is not treating autism; he or she is treating specific symptoms of autism. Often, when symptoms are treated, people with autism are better able to learn, communicate, and generally connect with others.

A girl who cared by Grandma is taking pills in bed
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Symptoms of Autism That Can Be Treated With Drugs

Not everyone with an autism spectrum disorder has the same symptoms, and not all symptoms can be treated with pharmaceuticals. Most often, when drugs are prescribed for people with autism, they are intended to address specific symptoms including behavioral issues, anxiety, depression, obsessive-compulsive disorder, attentional issues, hyperactivity, and mood swings from issues such as bipolar disorder.

Treating Anxiety and Depression

Selective serotonin reuptake inhibitors (SSRIs) are prescribed for anxiety, depression, and/or obsessive-compulsive disorder (OCD). Of these, only Prozac (fluoxetine) has been approved by the Food and Drug Administration (FDA) for both depression in children age 8 and older and OCD in children 7 and older.

Lexapro (escitalopram) is also approved for kids with depression that are age 12 or older. Three SSRIs that were approved for OCD are Luvox (fluvoxamine) for kids age 8 and older; Zoloft (sertraline) for children age 6 and older; and Anafranil (clomipramine) for kids age 10 and older. Wellbutrin is an antidepressant that works differently from the SSRI class of antidepressants and is not approved for pediatric use.

FDA Warning Regarding SSRI Drugs

The FDA has issued an advisory to patients, families, and health professionals to closely monitor adults and children taking antidepressants for signs of suicide. This is especially important at the beginning of treatment or when doses are changed.

Treating Behavioral Problems

Many autistic children have significant behavioral problems. Some can be managed by non-pharmaceutical treatments such as applied behavior analysis (ABA), Floortime therapy, etc. But when behaviors are out of control or dangerous, it may be time to consider antipsychotic medications. These work by reducing the activity of the neurotransmitter dopamine in the brain. There are two types of antipsychotics, including:

  • Older antipsychotic medications: Older antipsychotic medications such as haloperidol, thioridazine, fluphenazine, and chlorpromazine, may be effective in treating serious behavioral problems. But all, including haloperidol, can have serious side effects such as sedation, muscle stiffness, and abnormal movements, so these medications are only used if newer antipsychotics don't do the job.
  • Newer antipsychotic medications: Some of the newer "atypical" antipsychotics may be a better choice, particularly for children. One recent study showed that Risperdal (risperidone) and Abilify (aripiprazole) worked well to help control aggression and irritability in children. Both are FDA-approved to treat irritability in kids with autism; Risperdal is approved for children who are 5 or older, and Abilify is approved for kids 6 and up.

Treating Seizures

One in four people with autism spectrum disorder (ASD) also has a seizure disorder. Usually, they are treated with anticonvulsants such as Tegretol (carbamazepine), Lamictal (lamotrigine), Topamax (topiramate), or Depakote (valproic acid).

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.

Treating Inattention and Hyperactivity

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

Adderall (dextroamphetamine and amphetamine) is another stimulant that's often used in the same way as Concerta or Strattera to help with attention, focus, and behavior issues. Clorpres (clonidine), an antihypertensive, is sometimes prescribed for hyperactivity and impulsiveness as well.

Assessing Drug Options

All pharmaceuticals described in this article have the potential for side effects. Some, when prescribed for autism, are prescribed "off-label," meaning that they're prescribed for purposes other than that for which they were approved. Just remember that no pharmaceutical intervention comes without potential risks.

Consult With a Doctor

Because of the risk of any pharmaceutical intervention, it makes sense to use drugs only if and when symptoms are severe or uncontrollable by other means. Even then, it's critically important that you consult a medical doctor with experience in autism and, if appropriate, pediatrics.

Be sure that you understand the potential side effects. Ask your doctor whether any of these side effects could be dangerous and be sure you know what to do if any problems arise. Make a follow-up appointment too so your doctor can assess the success of the treatment and recommend any changes to the dosage.

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