Medication for Autism and ADHD
Parents of children with co-occurring ASD/ADHD report high rates of medication use. 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 in kids with autism to help reduce irritability and aggression. But some other drugs can also be beneficial.
Antipsychotics
While the interest in co-occurring ADHD and ASD symptoms has grown however, research is still limited. There are a variety of psychosocial treatment options for each disorder. However, only a few studies have evaluated the effectiveness of these treatments when they are combined with other symptoms. A better understanding of how co-occurring disorders develop and interact with time will be crucial to inform both pharmacological and psychosocial strategies.
Many people who suffer from ASD also suffer from the comorbidity of ADHD and other mental health disorders like depression or anxiety. There are many psychosocial treatments for these disorders, such as cognitive behavioral therapy (CBT), interpersonal therapy, and family therapy. These psychosocial treatments are more effective than pharmaceutical treatments for some people who have ASD/ADHD comorbidity.
Non-drug treatments are typically the best option for the most fundamental ASD symptoms, such as rigid thinking and poor social skills. These include behavioral training as well as peer support groups. For those suffering from comorbid ADHD and ASD symptoms such as irritability, aggression, and disruptive mood dysregulation disorder medication can be helpful. However the use of atypical antipsychotics has not been proven to reduce the fundamental ASD symptoms and the evidence supporting these drugs is weak at best.
The current theories suggest that symptoms of autism spectrum disorders (ASD) and ADHD are caused by alterations in neurotransmitter pathways. This is particularly 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.
Some of these abnormalities may be due to a decrease in brain activity in certain areas such as the striatum. To treat ADHD and ASD, several medications that modulate dopamine or glutamate levels are under investigation.
A variety of types are being investigated for the treatment of comorbid ADHD symptoms and ASD such as risperidone as well as aripiprazole and domperidone. A consensus on a nomenclature is pending for dopamine-antagonists.
As with all medication there are a variety of people who respond the same way to antipsychotics. Randomized controlled trials offer the most reliable information about risperidone or aripiprazole for people with ASD or ADHD. These trials utilized parallel, crossover and withdrawal designs. In general, the drugs perform better than placebo in reducing aggression and irritability and improving functioning. The drugs are generally well tolerated. One third of people who take these drugs will find that the drug works well for most or all of their symptoms. The remaining two-thirds of patients may only experience minor improvement.
Stimulants
Although non-medical care is not typically recommended for autism, medication could be beneficial for a few children and adults. Medications such as antipsychotics aid in reducing anxiety and reduce self-injurious behaviors and stimulants such as methylphenidate, which helps with ADHD symptoms, can help improve the ability to concentrate. Medication does not address core autism behaviors like repetitive or limited interest or difficulties in communicating. Many adults and children with autism also suffer from co-occurring mental health issues like depression, mood disorders, or anxiety that affect everyday functioning.
Irritability can be a major issue for children and adults with autism. Iampsychiatry can cause outbursts and self-injury, and difficulties with routines or transitions. Risperdal (Risperdal) and aripiprazole, (Abilify), are the only two medications that have been approved to treat autism-related irritability. These drugs are thought to work by altering dopamine, which is a brain system that is involved in emotion and decision-making.
The most commonly prescribed ADHD medication is methylphenidate such as Ritalin and mixed amphetamine salts that boost dopamine activity in the frontal lobe regions of the brain. Certain studies suggest that these drugs are as effective in patients with autism and ADHD as they are in those suffering from pure ADHD However, other studies indicate that they're not as helpful. However, it is important for parents to speak with their doctor to determine whether or whether the benefits outweigh the potential side effects of these medications.
Some researchers believe that second-line ADHD medications such as atomoxetine or guanfacine, may be more efficient in decreasing ADHD symptoms in people with autism. These drugs are believed to be effective by interfacing with the dopamine and norepinephrine systems, which are associated with mood and motivation.
Connor's psychiatrist and behavioral therapist are trying to teach him social skills and assist him in overcoming his anxieties. Despite these efforts hyperactivity and inattention can still hinder his development. His family decided to give him an ADHD medication to help him concentrate.
After three months, he's much more focused at school and in his daily activities. Parents are noticing that he can follow instructions more effectively, listen when someone speaks to him and participate in group activities. His mother claims that the medication has saved her life.
Benzodiazepines
The benzodiazepines comprise a category of drugs that reduce the central nervous system, producing sleepiness and a calm mood. These drugs are used to treat various conditions, including anxiety disorders, seizures, and insomnia. They target specific GABA receptors (gamma aminobutyric acid), a neurotransmitter that hinders brainwaves and communications between neurons. By keeping GABA receptors open longer and allowing them to open more the benzodiazepines improve inhibition and reduce the overactivity of excitatory neurons. The theory suggests that the most prominent characteristics of autism are caused by an imbalance between excitatory and inhibitory neurotransmissions in the brain. This theory is backed by animal models, which show that clonazepam is able to reverse autistic behaviors in mice with Dravet Syndrome, which is a type of epilepsy.
Anxiety is a frequent disorder that is a comorbidity for people with autism spectrum disorders. In some instances, anxiety is the motivation behind an individual's aggressive or self-injurious behavior. In others, it's a response to sensory issues that make life difficult and can trigger anxiety.
Antidepressants are one of the treatment options. They boost the levels of norepinephrine a chemical that is found in the brain believed to boost self-esteem and coping. They also reduce reuptakes of neurotransmitters like serotonin, dopamine and norepinephrine. This reduces anxiety and irritability. Atypical antipsychotics, such as risperidone (Risperdal) and Aripiprazole (Abilify) can assist with irritability, aggression, and Tourette syndrome in people with autism.
Melatonin may enhance the quality and length of sleep for adults suffering from ASD. There aren't any controlled studies in this population. Methylphenidate is a good option for treating ADHD in children who have ASD. However it's not as effective in children who are normal-developing.
Treatments for autism and ADHD can be dangerous when not used correctly. The most important thing to do is consult with your physician to determine the most appropriate medication and dosage for your child or teenager. Always follow the directions on the label of the medication. Do not abruptly stop or start taking your medication. This could be risky. You should seek immediate help when you suspect that you or someone else has taken too many medications. Record your child's weight and height frequently, along with their menstrual cycle to ensure the medication isn't causing unwanted adverse effects.
Medication Options
Both conditions are common in children with autism. Both disorders are typically treated with medications. The most commonly used ADHD medications -- methylphenidate, amphetamines, atomoxetine, Strattera, and guanfacine -- can also be used to treat the hyperactivity and impulsivity of autism.
A few children with autism exhibit severe aggression or irritability. These symptoms can be difficult for parents to manage by using only behavior-based strategies. Certain medications such as Abilify and Risperdal can reduce aggression, irritability and self-injury by the neurotransmitter dopamine. These medications have not been approved by the FDA to be used in conjunction with children with autism. However, they are sometimes prescribed 'off-label' for specific symptoms.
It is essential parents discuss with their pediatricians whether medication is suitable for their child. A number of studies show that children who are taking ADHD medication for autism that coexists have a better quality of life at home as well as at school, and make significant academic and social, as well as behavioral, progress.
Psychiatrists have been trained to assist children suffering from the symptoms of ADHD and autism. They can provide behavior-oriented parental training that involves manuals and classes for parents that teach them how to reduce disruptive behavior. They can also offer psychosocial therapies which focus on improving communication and relationships between the family members.
Some families, however prefer to use medication to manage their child's behavior. Some parents find that antipsychotics can have a calming effect on their child, which can improve irritability and aggression.
In the same way, a lot of children with autism also suffer from mental illness that interferes with their ability to function and learn like depression or anxiety. These disorders often co-occur and can hinder the effectiveness of therapy. Combining cognitive behavioral therapy with medication could be beneficial for these children. This approach is particularly helpful for children with a more severe autism disorder or who don't respond to other interventions.