Medication for Autism and ADHD
Parents of children who have ASD/ADHD co-occurring disorders report high levels of medication usage. However, research on psychopharmacological treatments is limited in both number and type.
Risperidone (Risperdal) and aripiprazole (Abilify) are the only medications approved by the FDA for use by children with autism to help reduce anger and irritability. But some other drugs can also be beneficial.
adhd and anxiety medication on co-occurring ADHD symptoms and ASD remains limited, despite the increasing interest. There are a variety of psychosocial treatment options that are available for each disorder however, few studies have evaluated effectiveness of treatments in the context of co-occurring symptoms. An improved understanding of how co-occurring disorders develop and interplay over time will be important for determining both pharmacological as well as psychosocial approaches.
Many people who suffer from ASD also have the comorbidity of ADHD and other mental health issues such as depression or anxiety. There are many psychosocial treatments for these disorders, including cognitive behavioral therapy (CBT), interpersonal therapy, and family therapy. These psychosocial treatments are more effective than pharmacological treatments for some people who have ADHD/ASD comorbidity.
For the core ASD symptoms like low social skills and rigid thinking, non-pharmacological interventions are usually preferred. These include peer support groups as well as behavioral training. The use of medication can help with the symptoms of ADHD/ASD that are co-morbid such as irritability, aggression, or disruptive mood dysregulation. However Atypical antipsychotics haven't been shown to improve the core ASD symptoms and the evidence supporting these medicines is limited at best.
Current hypotheses suggest that symptoms of autism spectrum disorders and ADHD are caused by alterations in neurotransmitter signalling pathways, especially those that are mediated by glutamate, dopamine, and serotonin.2 These changes affect prefrontal cortex and mesocorticolimbic circuitry that are involved in emotional regulation and behavior control.3
Certain of these disorders could result from a reduction in brain activity in specific regions such as the striatum. Thus, a range of drugs that are believed to regulate dopamine and glutamate are being investigated to help in the treatment of ADHD and ASD co-morbidities.
A variety of types are being investigated for treatment of the comorbid ADHD symptoms and ASD, including risperidone Aripiprazole, aripiprazole and domperidone. The development of a consensus name for dopamine antagonists is still in the works.
As with all medication it is not all patients respond the same to antipsychotics. The best available data on aripiprazole and the risperidone drug in adults suffering from ASD and ADHD are based on randomized controlled trials. These trials used crossover, parallel and withdrawal designs. In general, the medications work better than placebo in reducing irritability and aggression and enhancing the functioning. They are also generally tolerated. However, only one-third of people who are taking these drugs will find that they work for all or the majority of their symptoms. However, the other two-thirds will see only partial improvement.
Stimulants
Despite the fact that no medical treatment is generally suggested for autism, medication can be beneficial to some adults and children. Antipsychotics can ease anxiety and self-injurious behaviors and stimulants like methylphenidate (which helps with ADHD symptoms) can help improve concentration. The medication does not address the core autism-related behaviors such as repetitive and limited interest or difficulties communicating. Many adults and children with autism also suffer from mental health disorders such as anxiety, depression or mood disorders. These conditions can interfere with the daily functioning of a person.
Irritability can be a major issue for children and adults with autism. It can cause anger, self-injury, and difficulties with transitions or following routines. Risperdal (Risperdal) and aripiprazole, (Abilify) are the only two medications that have been approved for treating autism-related irritability. 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. It also contains mixed amphetamines salts that increase dopamine levels in the frontal regions of the brain. Some studies suggest that these drugs are as effective in patients with autism and ADHD as they are in those who have pure ADHD however other studies indicate that they are less effective. Regardless, it's important for parents to consult their doctor to determine whether or not the benefits outweigh potential side effects of these medications.
Some researchers believe that second line ADHD medications like atomoxetine and guanfacine, may be more effective in reducing ADHD symptoms among people with autism. These drugs are believed to be effective by interfacing with the norepinephrine and dopamine systems, which are linked with mood and motivation.
Connor's therapist and psychiatrist are striving to teach him social skills and assist him in overcoming his fears. However, even with these interventions hyperactivity and inattention can hinder the pace of his development. So his family decided to try an ADHD medication to help him concentrate.
After three months, he's become more focused at school and in his daily activities. Parents can tell that he's more focused, listens to what others are saying and is more involved in group activities. His mother says the medication is a lifesaver.
Benzodiazepines
The benzodiazepines comprise a category of drugs that reduce the central nervous system, leading to tranquility and sleep. They are utilized to treat a wide range of ailments, including anxiety disorders, seizures and insomnia. They target specific GABA receptors (gamma aminobutyric acid) which is a neurotransmitter, which hinders brainwaves and communications between neurons. By opening GABA receptors and keeping them open for longer benzodiazepines enhance inhibition and stop excitatory neurons from overactivating. The idea is that the characteristic autism-related behaviors are fueled by an imbalance in the excitatory and inhibitory neurons in the brain. Animal models support this hypothesis by demonstrating that clonazepam reverses certain autistic behaviors in mice with Dravet syndrome, which is a type of epilepsy.
Anxiety is a typical co-occurring condition among people with autism spectrum disorders. In some cases anxiety is the cause of aggressive or self-injurious behaviors. In other instances it's due to sensory issues that cause difficulty and trigger anxious feelings.
Antidepressants are among the treatments available. They boost the levels of norepinephrine, which is a chemical found in the brain believed to boost self-esteem and coping. They also lower the reuptake of neurotransmitters serotonin and norepinephrine, which can reduce irritability as well as anxiety. Atypical antipsychotics like risperidone and aripiprazole can aid people suffering from autism, aggression, irritability and Tourette syndrome.
There's some evidence that melatonin can improve the duration and quality of sleep in adults suffering from ASD. However, controlled studies are lacking in this population. Methylphenidate can be effective in treating ADHD in children with ASD. However it's not as effective for children with normal development.
If they aren't used correctly, the medication for autism and ADHD could be harmful. The most important thing to do is work with your doctor to determine the right dosage and medication for your child or teenager. Always adhere to the instructions on the label of the medication. Do not stop or begin taking your medication abruptly, as it can be extremely dangerous. If you suspect that you or someone you know has taken too much, seek emergency help immediately. Also, keep track of your child's weight and height regularly as well as their menstrual cycle, to ensure that the medication aren't causing any unwanted side effects.
Medication Options
Many children with autism suffer from ADHD and it's normal for both conditions to coexist. Both are usually treated with medications. The most commonly used to treat ADHD -such as methylphenidate (Ritalin), amphetamines (Adderall, Vyvanse), atomoxetine (Strattera) and Guanfacine (Intuniv, Tenex) -are effective in treating the hyperactivity and impulsivity associated with autism.
A few children with autism have severe irritability or aggression. These behaviors can be difficult for parents to manage with only behavioral strategies. Abilify and Risperdal are medications that can reduce aggression and self-injury. They affect the neurotransmitter dopamine. These medications are not approved by the FDA to be used in conjunction with children with autism. However they are often prescribed 'off-label' to treat specific symptoms.
It is important for parents to consult their pediatricians to determine if medication is appropriate for their child. Many studies have proven that children who take ADHD medication to treat Autism can enjoy a higher living conditions both at home and at school, and make significant progress in their academic and behavioral abilities.
Psychiatrists are trained in helping children deal with the symptoms of autism and ADHD. They can recommend behaviorally oriented parent training, which involves classes that are both group-based and manual. These programs teach parents how to manage disruptive behaviors. They can also provide psychosocial therapies that focus on improving relationships and communication between family members.
However, some families prefer to rely on medication to manage their child's behavior. Some parents have found that the antipsychotics' calming effects can help reduce the child's aggression, anger as well as self-injury. They may be willing to consider this option if other treatments aren't working.
Similar to the above the majority of children who suffer from autism also have mental health issues that affects their ability to learn and function, for example anxiety or depression. These conditions are often co-occurring and can interfere with the effectiveness of therapy. Combining cognitive behavior therapy with medication can be beneficial for these children. This approach is especially helpful for children who have a more severe form of autism or who don't respond to other treatments.