Medication for Autism and ADHD
Parents of children who have co-occurring ASD/ADHD report high rates of medication usage. However, research on psychopharmacological treatments is limited in both number and type.
Risperidone and aripiprazole are known as Risperdal and Abilify are the only two medications that have been approved by the FDA to be used in children with autism for reduction of irritability and aggressive behavior. Other medications can be beneficial.
Antipsychotics
Research on co-occurring ADHD symptoms and ASD remains insufficient despite the growing interest. There are a myriad of psychosocial treatment options for each disorder. However, very few studies have evaluated the effectiveness of these treatments in the context of coexisting symptoms. It is important to gain a better understanding of the interactions between co-occurring disorders and how they develop over time. This will aid in the development of both pharmacological and psychosocial approaches.
Many people with ASD have ADHD and other mental disorders like anxiety or depression. These disorders can be treated with various psychosocial therapies, including cognitive behavior therapy (CBT), family therapy, and interpersonal therapy. These psychosocial treatments are more effective than pharmacological therapies for people with comorbid ADHD/ASD.
Non-drug treatments are typically the best option to treat the core ASD symptoms, such as rigid thinking and poor social skills. They include behavioral training and peer support groups. The use of medication can help with the symptoms of ADHD/ASD that are co-morbid like irritability and aggression, or disruptive mood dysregulation disorder. Atypical antipsychotics do not improve the core ASD symptoms, and evidence is at best limited.
The current theories suggest that symptoms of autism spectrum disorders (ASD) and ADHD are caused by abnormalities in neurotransmitter pathways, especially those involving glutamate dopamine, and serotonin.2 These changes affect the mesocorticolimbic prefrontal cortex which is involved in the regulation of emotion and behavior control.
Certain of these disorders could be due to a decrease in brain activity in certain regions, such the striatum. Thus, a range of medications that are known to alter the levels of glutamate and dopamine are being studied for use in the management of ADHD and ASD co-morbidities.
Dopamine antagonists of various types are being studied in the treatment of comorbid ADHD and ASD symptoms such as risperidone (Risperdal, Janssen Pharmaceutical Inc.; Titusville, NJ), aripiprazole (Abilify, Otsuka America Pharmaceutical Inc.; Rockville, MD) and domperidone (Motilium, Johnson & Johnson; New Brunswick, NJ). A consensus on a nomenclature is waiting for dopamine-antagonists.
Antipsychotics are just like any other medication. The most current data on aripiprazole and risperidone in adults with ASD and ADHD are based on randomized controlled trials. These trials employed crossover, parallel, and withdrawal designs. In general, these medications are more effective than placebo in cutting down on aggression, irritability and improving function. adhd medications for adults are also generally tolerated. One-third of those who take these drugs will find that the drug is effective for the majority or all of their symptoms. The other two-thirds may only experience a slight improvement.
Stimulants
Despite the fact that non-medical treatment is usually suggested for autism, medication can be beneficial to some children and adults. Antipsychotics can ease anxiety and self-injurious behaviors, while stimulants such as methylphenidate (which aids in reducing ADHD symptoms) can boost concentration. These medications do not address the root of autism behaviors like repetitive or limited interest or difficulties in communicating. Many children and adults with autism also suffer from co-occurring mental health disorders such as depression, mood disorders or anxiety that affect everyday functioning.
Autism can also trigger irritability in children and adults. This can lead outbursts and self-injury, and difficulty with routines or transitions. Risperdal (Risperdal), and aripiprazole (Abilify), are the only drugs that are approved to treat autism-related irritability. These drugs are thought to work by affecting dopamine, a brain system that is involved in decisions and emotions.
The most commonly prescribed ADHD medication is methylphenidate like Ritalin. It also includes mixed amphetamines, which increase dopamine levels in the frontal lobes of the brain. Certain studies suggest that these medications are equally effective in treating patients with autism and ADHD as they are for people with pure ADHD. However other studies suggest they may not be as efficient. Regardless, it's important for parents to speak with their doctor about whether or not the benefits outweigh possible side effects from these drugs.
Some researchers believe that second-line ADHD medications like atomoxetine and Guanfacine, could be more effective in reducing ADHD symptoms in people with autism. These drugs are believed be effective by interfacing with the norepinephrine and dopamine systems, which are connected with mood and motivation.
Connor's therapist and psychiatrist are trying to teach him how to be social and help him cope with his anxieties. However, even with these treatments, the hyperactivity and inattention can hinder the progress of his improvement. 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. His parents can see that he's more attentive and listens to what other people speak and participates in group activities. His mother claims that the medication has saved her life.
Benzodiazepines
The benzodiazepines comprise a category of drugs that slow down the central nervous system, leading to an euphoria and calm mood. These drugs are used to treat many conditions, such as seizures, anxiety disorders and insomnia. They target specific receptors for the neurotransmitter GABA (gamma-aminobutyric acid), which inhibits brain waves and inhibits communication between neurons. By opening GABA receptors and keeping them open for longer, benzodiazepines boost inhibition and prevent excitatory neurons from becoming overactive. The idea is that the hallmark behavioral features of autism are fueled by an imbalance between excitatory and inhibitory neurotransmissions in the brain. This theory is backed by animal models that show that clonazepam can reverse certain autism-related behaviors in mice suffering from Dravet Syndrome, a form of epilepsy.
Anxiety is often a co-occurring disorder in people with autism spectrum disorders. In some instances, anxiety is the cause of aggressive or self-injurious behaviors. In other cases, anxiety is a reaction to sensory issues that can make life difficult.
Antidepressants are one of the treatments available. They increase the amount of norepinephrine, which is a chemical found in the brain believed to improve coping and self-esteem. They also decrease the reuptake of neurotransmitters like serotonin, norepinephrine and dopamine. This can help reduce irritability and anxiety. Atypical antipsychotics like risperidone (Risperdal) and aripiprazole (Abilify) can assist with irritability, aggression, and Tourette syndrome in people who have autism.
Melatonin could increase the duration and quality of sleep for people with ASD. There are no controlled studies for this group. Methylphenidate is a good option for treating ADHD in children with ASD. However it's not as effective in typical-developing kids.
If they are not used correctly, the medication for autism and ADHD could be harmful. It's crucial to work with your doctor to find the right medication and dosage for your child or teen. Always follow the directions on the label of the medication. Do not abruptly stop or commence taking your medication. This could be risky. You should seek immediate assistance in the event that you suspect you or someone else has taken too many medications. Note your child's weight and height on a regular basis, along with their menstrual cycle to ensure that the medication doesn't cause unwanted adverse effects.
Medication Options
Both conditions are common in children with autism. Both disorders are typically treated with medications. The most common ADHD medications - amphetamines, methylphenidate, atomoxetine, Strattera, and guanfacine are also used to treat the impulsivity and hyperactivity of autism.
Additionally, some children with autism are susceptible to severe irritability and aggression, and those symptoms can be difficult to manage using methods for managing behavior on their own. The use of medications like Abilify and Risperdal can reduce aggression, irritability and self-injury by affecting a neurotransmitter called dopamine. These medications are not approved by the FDA for use with children with autism, however they can be prescribed "off-label" to treat specific symptoms.
It is crucial parents discuss with their pediatricians whether medication is appropriate for their child. Several studies show that kids who are on ADHD medications for coexisting autism may enjoy a better quality of life both at home and at school, and make significant academic, behavioral and social progress.
Psychiatrists are trained to assist children deal with the symptoms of autism and ADHD. They can suggest behavior-based parent training that includes manuals and classes that teach parents how to reduce disruptive behavior. They can also provide psychosocial services that focus on improving communication and relationships among family members.
Some families, however prefer to use medication to control their child's behavior. Parents have reported that the calming effects of antipsychotics can help improve their child's irritability, aggression as well as self-injury. They may be willing to consider this option if other methods don't work.
In the same way, many children with autism also suffer from mental illness that affects their ability to learn and function like anxiety or depression. These conditions are often co-occurring and can interfere with therapy effectiveness. For these children using a combination of cognitive therapy and medication may be helpful. This approach is particularly helpful for kids who have a more severe autism disorder or those who do not respond to other therapies.