Medication for Autism and ADHD
Parents of children and youth who suffer from co-occurring ASD and ADHD report high rates of use of medications. 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 for use in kids with autism. They can help decrease irritability and aggression. Other medications can be beneficial.
Antipsychotics
While interest in co-occurring ADHD and ASD symptoms has grown however, research is still limited. There are a variety of psychosocial treatment options that are available for each disorder, but few studies have characterized treatment effectiveness in the context of co-occurring symptoms. It is crucial to gain a better understanding of the interaction between co-occurring disorders and how they change over time. This will aid in the development of both pharmacological and psychosocial approaches.
Many people suffering from ASD also have the comorbidity of ADHD and other mental health conditions such as anxiety or depression. Several psychosocial treatments exist for these disorders, such as cognitive behavioral therapy (CBT) as well as interpersonal therapy and family therapy. These psychosocial treatments may be more effective than pharmacological treatment for those suffering from comorbid ADHD and ASD.
For the core ASD symptoms like low social skills and rigid thinking, non-drug interventions are typically preferred. These include peer support groups and behavioral training. Medicines can be beneficial for the symptoms of ADHD/ASD that are co-morbid, such as irritability and aggression, or mood dysregulation disorder. However Atypical antipsychotics haven't been proven to reduce core ASD symptoms, and the evidence for these drugs is weak at best.
Current hypotheses suggest symptoms of autism spectrum disorders (ASD) and ADHD are caused by alterations in neurotransmitter pathways, especially those that involve glutamate, dopamine and serotonin.2 This changes impact prefrontal cortex, mesocorticolimbic, which is involved in emotional regulation and behavior control.
Some of these abnormalities may result from a reduction in brain activity in specific regions like the striatum. Therefore, a number of drugs that are believed to modulate dopamine and glutamate are being investigated for use in the management of ADHD and ASD co-morbidities.
Several types of dopamine antagonists are being studied in the treatment of comorbid ADHD and ASD symptoms and symptoms, including risperidone (Risperdal, Janssen Pharmaceutical Inc.; Titusville, NJ) and Aripiprazole (Abilify, Otsuka America Pharmaceutical Inc.; Rockville, MD), and domperidone (Motilium, Johnson & Johnson; New Brunswick, NJ). The emergence of a common nomenclature for dopamine antagonists is still in the works.
Antipsychotics are no different than any other medication. The most reliable data available on risperidone and aripiprazole in adults suffering from ASD and ADHD come from controlled, randomized trials. These trials used crossover, parallel and withdrawal strategies. In general, the drugs perform better than placebo in reducing aggression and irritability and improving functioning. They are also generally tolerated. However, only one-third of people who are taking these drugs will find that they work well for all or most of their symptoms. However, the remaining two-thirds of them will see only minor improvement.
Stimulants
Despite the fact that non-medical treatment is typically suggested for autism, medication can be beneficial to some adults and children. Medications such as antipsychotics help to ease anxiety and decrease self-injurious behavior; and stimulants like methylphenidate, which helps with ADHD symptoms, can enhance the ability to concentrate. However, they don't address core autism behaviors such as repetitive and restricted interests or difficulty communicating. Many children and adults with autism also suffer from co-occurring mental health issues such as depression, mood disorders, or anxiety that hinder daily functioning.
Irritability can be a major issue for children and adults with autism. It can cause anger outbursts, self-injury or difficulty with transitions or adhering to routines. Risperdal (Risperdal) and aripiprazole (Abilify), are the only drugs that have been approved to treat autism-related anger. They are believed to affect dopamine, a brain system that is involved in decisions and emotions.
The most commonly prescribed ADHD medications are methylphenidate products such as Ritalin and mixed amphetamine salts which increase dopamine levels in the frontal lobes of the brain. Certain studies suggest that these medications are just as effective in treating those suffering from autism and ADHD than they are for people with pure ADHD. However other studies suggest they may not be as effective. It's important that parents discuss with their doctor whether the benefits of these drugs outweigh any potential side effects.
Some researchers believe that second-line ADHD medications such as Guanfacine and atomoxetine may be more helpful in decreasing ADHD symptoms for people with autism. These medications are thought to affect the dopamine-norepinephrine axis, which is associated with motivation and mood.
Connor's psychiatrist, and behavioral therapists are working hard to help him develop social skills and cope with his anxiety. However, even with these interventions hyperactivity and inattention can hinder the pace of his progress. His family decided to give him an ADHD medication in order to aid in his focus.
After three months he is more focused in school and his daily activities. His parents can see that he's more attentive, listens to what others say and participates in group activities. His mother says that the medication has saved her life.
Benzodiazepines
The benzodiazepines is a group of drugs which slows the central nervous system and causes sleepiness. These medications are used to treat various conditions, including 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 for longer and allowing them to be opened more frequently benzodiazepines enhance inhibition and prevent the overactivity of excitatory neurons. The theory is that the defining features of autism are caused by an imbalance in excitatory and inhibitory neurotransmissions within the brain. Animal models support this idea, showing that clonazepam reverses some autistic behaviors in mice suffering from Dravet syndrome, which is a type of epilepsy.
Anxiety is often a comorbid disorder among people with autism spectrum disorders. In some cases anxiety may be the primary reason for a person's violent or self-injurious behavior. In other instances anxiety is a response to sensory issues which can make life difficult.
Antidepressants are among the treatment options. They increase the level norepinephrine a chemical that is found in the brain that is thought to boost self-esteem and coping. They also reduce the reuptake rate of neurotransmitters norepinephrine and serotonin, which can reduce irritability as well as anxiety. Atypical antipsychotics, like risperidone (Risperdal) and Aripiprazole (Abilify) can assist with irritability, aggression, and Tourette syndrome in those with autism.
Melatonin could improve the quality and duration of sleep for adults with ASD. However, controlled studies aren't available for this group. Methylphenidate has proven effective in treating ADHD symptoms in children who have ASD however, it's not as efficient as it is for typical children.
The medications for autism and ADHD can be dangerous when they're not utilized properly. It's crucial to work with your doctor to determine the right medication and dosage for you child or teen. Always adhere to the instructions on the label of the medication. Do not stop or change the dosage of your medications suddenly, which can be extremely dangerous. You should seek immediate help when you suspect that you or someone else has taken too much medication. Record your child's weight and height frequently and also their menstrual cycle to make sure the medication isn't causing any undesirable adverse side effects.
Medication Options
Many kids with autism also suffer from ADHD and it's common for these two conditions to coexist. weblink are often treated with medications. The most frequently used to treat ADHD -- methylphenidate (Ritalin) amphetamines (Adderall, Vyvanse), atomoxetine (Strattera) and Guanfacine (Intuniv, Tenex) -are effective in treating the impulsivity and hyperactivity associated with autism.
In addition, some children with autism are prone to severe irritability and aggression, and those symptoms are difficult to manage using behavioral strategies alone. Abilify and Risperdal are medications that reduce aggression as well as self-injury. They work by affecting the neurotransmitter dopamine. These medications are not approved by the FDA for use with children with autism, however they are sometimes prescribed "off-label" to treat specific symptoms.
It is important for parents to consult their pediatricians to determine if medication is appropriate for the child. Many studies have proven that children taking ADHD medication to treat autism that coexists can have better living conditions both at home and at school, and can make significant progress in academics and behavior.
Psychiatrists are trained to assist children manage symptoms of autism and ADHD. They can recommend behaviorally oriented parent training, which includes manual and group-based programs that teach parents how to manage disruptive behaviors. They can also provide psychosocial services which focus on improving relationships and communication between family members.
However, some families opt to use medication to control their child's behavior. Some parents have found that antipsychotics have a soothing impact on their child which can decrease irritability as well as aggression.
Similarly as many children with autism also suffer from a mental health condition that hinders their ability to learn and function, like anxiety or depression. These disorders often co-occur and can affect the effectiveness of therapy. Combining cognitive-behavioral therapy with medication may be beneficial for these children. This approach is particularly helpful for children with an autism disorder that is more severe or who don't respond to other interventions.