Medication for Autism and ADHD
Parents of children who have co-occurring ASD/ADHD report high rates of use of medications. However, research on psychopharmacological treatments is limited in both number and type.
Risperidone and aripiprazole, also called Risperdal and Abilify are the only drugs that have been approved by the FDA to be used in children with autism for reduction of irritability and aggressive behavior. But other drugs may also be beneficial.
Antipsychotics
While interest in co-occurring ADHD and ASD symptoms has grown, research remains limited. There are many psychosocial treatment options for each disorder. However, very few studies have assessed the effectiveness of these treatments in the context of coexisting symptoms. It is crucial to gain a better understanding of the interaction between co-occurring disorders and how they develop over time. This will inform both pharmacological and psychosocial approaches.
Many people with ASD suffer from ADHD and other mental disorders such as depression or anxiety. There are many psychosocial treatments for these disorders, including cognitive behavioral therapy (CBT) and interpersonal therapy and family therapy. These psychosocial therapies may be more effective than pharmacological treatments for some people with the comorbidity of ADHD and ASD.
For the most fundamental ASD symptoms, such as low social skills and rigid thinking, non-pharmacological interventions are typically preferred. These 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 mood dysregulation disorder. However Atypical antipsychotics haven't been proven to help improve core ASD symptoms and the evidence for these medications is sporadic at best.
Current theories suggest that the symptoms of autism spectrum disorders (ASD) and ADHD are mediated through abnormalities in neurotransmitter pathways. This is particularly those involving glutamate dopamine, and serotonin.2 This changes impact mesocorticolimbic and prefrontal cortex which is involved in the regulation of emotions and control of behavior.
Certain of these disorders could result from a reduction in brain activity in specific regions, such the striatum. To treat here are the findings and ASD there are a variety of medications that alter dopamine or glutamate levels are being investigated.
Different dopamine antagonists are being investigated for the treatment of the comorbid ADHD and ASD 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). A consensus nomenclature is in the process of being developed for dopamine antagonists.
Antipsychotics are no different than any other medication. Randomized controlled trials offer the most reliable information about the effects of aripiprazole or risperidone on adults with ASD or ADHD. These trials employed parallel crossover and withdrawal strategies. In general, these drugs are more effective than placebo at reducing irritability, aggression and enhancing function. They are also generally well tolerated. One-third of those who take these medications will find that the drug works well for most or all of their symptoms. The other two-thirds may only experience a slight improvement.
Stimulants
Although non-medical care is typically recommended for autism, medication may be beneficial for a few children and adults. Antipsychotics can ease anxiety and self-injurious behavior and stimulants like methylphenidate (which helps with ADHD symptoms) can boost concentration. However, they don't address core autism behaviors such as repetitive and restricted activities or difficulty communicating. Many adults and children with autism also suffer from co-occurring mental health disorders like depression, mood disorders, or anxiety that affect everyday functioning.
Autism can also trigger anger in adults and children. This can result in outbursts or self-injury, and difficulty with routines or transitions. Risperdal (Risperdal) and aripiprazole, (Abilify), are the only two medications that have been approved for treating autism-related irritation. The drugs are believed to affect dopamine, a brain organ that is involved in decisions and emotions.
The most commonly prescribed ADHD medication is methylphenidate like Ritalin. It also contains mixed amphetamines salts that 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 some studies suggest they may be less efficient. Whatever the case, it's crucial for parents to speak with their doctor to determine whether or the benefits outweigh any potential adverse effects of these drugs.
Some researchers believe that second-line ADHD medications like atomoxetine and guanfacine may be more helpful in decreasing ADHD symptoms in people with autism. These drugs are believed to work by interfering with the dopamine-norepinephrine system that is associated with motivation and mood.
The therapist and psychiatrist for Connor are striving to teach him how to be social and assist him in overcoming his anxiety. However, even with these treatments however, his hyperactivity and lack of attention can hinder the progress of his improvement. His family decided to give him an ADHD medication to help him concentrate.
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 more effectively, listen when someone speaks to him, and take part in group activities. His mother says that the medication is a lifesaver.
Benzodiazepines
The benzodiazepines are a group of drugs that slow down the central nervous system, resulting in sleepiness and a calm mood. These drugs are used to treat various conditions, such as seizures, anxiety disorders and insomnia. They target specific receptors for the neurotransmitter GABA (gamma-aminobutyric acid) which blocks brain waves and inhibits communication between neurons. By keeping GABA receptors open for longer, and allowing them to open more, benzodiazepines increase inhibition and reduce excitatory neuron overactivity. The theory holds that the hallmark features of autism result from an imbalance in excitatory and inhibitory neurotransmissions in the brain. This theory is supported by animal studies which demonstrate that clonazepam reverses certain autistic behaviors in mice with Dravet Syndrome, a form of epilepsy.
Anxiety is often a co-occurring disorder among people with autism spectrum disorders. In some instances, anxiety is the cause of self-injurious or aggressive behavior. In other instances it's due to sensory issues that cause difficulty and trigger anxious feelings.
Antidepressants are among the treatment options. They increase the level norepinephrine, a chemical in the brain believed to boost self-esteem and coping. They also decrease the reuptake of neurotransmitters serotonin and norepinephrine which can reduce irritability as well as agitation. Atypical antipsychotics, such as risperidone and aripiprazole are able to aid people suffering from autism, anger, irritability, or Tourette syndrome.
Melatonin can enhance the quality and length of sleep for people with ASD. However, studies that have been controlled aren't available for this group. Methylphenidate is effective for treating ADHD symptoms in children suffering from ASD however it's not as efficient as it is for generally developing children.
The medications for autism and ADHD could be harmful when not used correctly. The most important thing is to consult with your physician to find the best dosage and medication for your child or teenager. Always adhere to the instructions on the label of the medication. Do not abruptly stop or start taking your medication. This can be dangerous. If you suspect you or someone you know has taken too much, seek immediate help. Record your child's weight and height on a regular basis, along with their menstrual cycle to ensure that the medication doesn't cause undesirable adverse side effects.
Medication Options
Both conditions are common in children with autism. Both are usually treated with medications. The medications that are most frequently used to treat ADHD -- methylphenidate (Ritalin) amphetamines (Adderall, Vyvanse), Atomoxetine (Strattera) and Guanfacine (Intuniv, Tenex) -are effective in treating the hyperactivity and impulsivity that are associated with autism.
Some children with autism also exhibit extreme aggression or irritability. These behaviors can be difficult for parents to manage using only behavioral strategies. The use of medications like Abilify and Risperdal can help to reduce aggression self-injury, irritability, and self-injury by altering a neurotransmitter known as dopamine. These medications aren't endorsed by the FDA to be used with children with autism, but they can be prescribed "off-label" to treat specific symptoms.
It is crucial for parents to discuss with their pediatricians if the medication is suitable for their child. Many studies have proven that children who are taking ADHD medication to treat autism that coexists can enjoy a higher quality of life at home and at school, and may make significant progress in academics and behavior.
Psychiatrists have been trained to assist children who suffer from the symptoms of ADHD and autism. They can provide behavior-oriented parental training that includes manuals as well as classes for parents that teach them how to manage disruptive behavior. They can also provide psychosocial treatment that focuses on improving communication and relationships between family members.
Some families, however prefer to use medication to manage their child's behavior. Certain parents find that antipsychotics have a soothing effect on their child which can reduce irritability and aggression.
Similar to the above, many children who have autism also suffer from a mental health condition that impacts their ability to learn and function, such as depression or anxiety. These disorders are frequently co-occurring and can hinder the effectiveness of therapy. Combining cognitive behavior therapy with medication may be beneficial for children with these disorders. This approach is particularly beneficial for kids who have a more severe autism disorder or who do not respond to other treatments.