Medication for Autism and ADHD
Parents of children with co-occurring ASD/ADHD report 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 two medications approved by the FDA for use by children with autism. They can help decrease anger and irritability. Other drugs may be beneficial.
Antipsychotics
Research on co-occurring ADHD symptoms and ASD is still insufficient, despite the growing interest. There are a variety of psychosocial treatment options that exist for each disorder, however, few studies have evaluated effectiveness of treatments in the context of co-occurring symptoms. A better understanding of how co-occurring psychiatric disorders develop and interact over time will be important for determining both pharmacological as well as psychosocial strategies.
Many people suffering from ASD have ADHD as well as other mental illnesses such as depression or anxiety. These conditions can be treated using various psychosocial treatments, including cognitive behavior therapy (CBT) and family therapy, as well as interpersonal therapy. These psychosocial treatments are more effective than pharmacological treatments for people with ADHD/ASD comorbidity.
For core ASD symptoms such as poor social communication skills and rigid thinking, non-pharmacological interventions are usually preferred. They include behavioral training and peer support groups. For those suffering from comorbid ADHD and ASD symptoms such as irritability, aggression, and disordered mood dysregulation, medications can be helpful. However, atypical antipsychotics have not been proven to help improve the core ASD symptoms and the evidence for 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 those that involve glutamate, dopamine and serotonin.2 This changes impact mesocorticolimbic prefrontal cortex which is involved in the regulation of emotions and control of behavior.
A few of these issues are believed to be due to a decrease in activity in certain brain regions, like the striatum. Therefore, a number of medications known to regulate dopamine and glutamate are being investigated to help in the treatment of ADHD and ASD comorbidities.
A variety of types are being investigated for treatment of co-occurring ADHD symptoms and ASD such as risperidone, aripiprazole, and domperidone. The emergence of a consensus label for dopamine antagonists is in the process of being developed.
Like all medications, not everyone responds the same way to antipsychotics. The most current data on risperidone and aripiprazole in adults suffering from ASD and ADHD come from randomized controlled trials. These trials utilized crossover, parallel, and withdrawal designs. In general, the drugs work better than placebo in reducing aggression and irritability and improving functioning. They are also generally tolerated. One third of people who use these medications will find that the drug is effective for the majority or all of their symptoms. The remaining two-thirds of patients may only experience minor improvement.
Stimulants
Although non-medical care is typically recommended for autism, medication could be beneficial for a few adults and children. Medications such as antipsychotics aid in reducing anxiety and reduce self-injurious behaviors; and stimulants like methylphenidate, which aids in the treatment of ADHD symptoms, can enhance the ability to focus. Medication does not address core autism behaviors like repetitive and limited interest or difficulties in communicating. Many children and adults who are autistic also suffer from mental health conditions such as anxiety, depression or mood disorders. These conditions can cause problems with daily functioning.
Irritability is a different issue for adults and children with autism. This can lead to anger, self-injury, and difficulties in navigating routines or transitions. 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 involved in emotions and decisions.
The most frequently prescribed ADHD medication are methylphenidate, like Ritalin and mixed amphetamine salts which increase dopamine activity in frontal lobes of our brain. Some studies suggest that these medications are as effective in patients with autism and ADHD as they are in those suffering from pure ADHD however other studies suggest that they're not as beneficial. It's important that parents discuss with their doctor if the benefits of these medications outweigh any potential negative side effects.
Some researchers believe that second-line ADHD medications such as atomoxetine or Guanfacine, could be more effective in reducing ADHD symptoms among people with autism. These drugs are believed work by interacting with the norepinephrine and dopamine systems, which are linked with mood and motivation.
Connor's psychiatrist, as well as his the therapist for behavioral issues, are trying to help him improve his social skills and cope with his anxiety. However, even with these treatments, the 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's more focused at school and in his daily activities. His parents are also noticing that he is able to follow directions better, listen when someone speaks to him and take part in group activities. His mother says the medication is an absolute lifesaver.
Benzodiazepines
The benzodiazepines are a class of drugs that slow down the central nervous system, resulting in sleepiness and a calm mood. They are used to treat a broad variety of ailments that include anxiety disorders, seizures and insomnia. They target specific receptors for the neurotransmitter GABA (gamma-aminobutyric acid) which blocks brain waves and blocks communication between neurons. By opening GABA receptors and keeping them open longer benzodiazepines enhance inhibition and stop excitatory neurons from becoming hyperactive. The theory is that hallmark behavioral features of autism are caused by an imbalance in the excitatory and inhibitory neurons in the brain. This theory is supported by animal models which demonstrate that clonazepam reverses certain autism-related behaviors in mice suffering from Dravet Syndrome, a type of epilepsy.
Anxiety is often a comorbid disorder in people with autism spectrum disorders. In some cases, anxiety can be the cause of self-injurious or aggressive behavior. In other instances it's a reaction to sensory issues that can make life difficult and can trigger anxiety.
Treatment alternatives include antidepressants that are believed to enhance self-esteem and coping abilities by increasing the levels of the chemical norepinephrine in the brain. They also lower the reuptake of neurotransmitters norepinephrine and serotonin, which can reduce irritability as well as agitation. Atypical antipsychotics, such as risperidone (Risperdal) and Aripiprazole (Abilify) are able to help with aggression, irritability and Tourette syndrome in people who have autism.
Melatonin could increase the duration and quality of sleep for people with ASD. However, controlled adhd medication pregnancy aren't available for this group. Methylphenidate is effective in treating ADHD symptoms in children who have ASD however, it's not as effective as it is in typical children.
If they aren't used correctly, medications for autism and ADHD could be harmful. The most important thing to do is work with your doctor to determine the most appropriate medication and dosage for your child or teen. Always follow best adhd medication for adults with anxiety on the label of the medication. Do not abruptly stop or start taking your medication. This could be risky. If you suspect you or someone you know has taken too much, seek emergency help immediately. Keep track of your child's weight and height frequently, along with their menstrual cycle to make sure the medication isn't causing any unwanted adverse side effects.
Medication Options
Many children with autism suffer from ADHD and it's not uncommon for these two conditions to coexist. Both conditions are often treated with medications. The most commonly used ADHD medications -- amphetamines and methylphenidate, Strattera, and guanfacine can also be used to treat the impulsivity and hyperactivity of autism.
Additionally, some children with autism are susceptible to extreme irritability and aggression and these symptoms are difficult to control with behavioral strategies alone. Medications like Abilify and Risperdal can help to reduce aggression self-injury, irritability, and self-injury by affecting a neurotransmitter called 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 suitable for their child. Several studies show that kids who are taking ADHD medication for autism that coexists may enjoy a better quality of life at home and at school, and may make significant academic, behavioral and social progress.
Psychiatrists have been trained to assist children suffering from the symptoms of ADHD and autism. They may recommend behaviorally focused parenting training that involves manual and group-based programs that teach parents how to manage disruptive behavior. They also offer psychosocial therapies that focus on improving communication and relationships between the family members.
Certain families, however, prefer to use medication to control their child’s behavior. Parents have reported that the calming effects of antipsychotics can help reduce their child's irritability, aggression and self-injury, and they might be willing to consider this option if other methods don't work.
Similarly the majority of children who suffer from autism also suffer from mental health issues that affects their ability to learn and function, for example depression or anxiety. These disorders often co-occur and may affect the effectiveness of therapy. Combining cognitive behavioral therapy with medication can be beneficial for children. This approach is particularly helpful for children with a more severe form of autism or who don't respond to other treatments.