A number of medications are used for the management of Autism Spectrum Disorder (ASD) in conjunction with therapeutic intervention. Medications have been proven to have effects on irritability, hyperactivity, and repetitive behaviours associated with ASD, however, they may also have associated adverse effects and are recommended to be prescribed only when a severe impairment or risk of injury is present.We are not medical doctors and as such are not qualified to prescribe medications to children or adults. However we frequently get asked about the use of medications with children with Autism and Developmental Disabilities. Our advice to parents and carers is to seek the professional opinion of your Paediatrician in regards to medications, if you are looking to cease/ reduce or increase a medication that has been prescribed to your child again do this in consultation with the prescribing specialist.
However given the large number of questions we are asked in regard to medications we have summarised some of the current research available in regard to medication and children with Autism and Developmental Disabilities.
Medications have both generic and brand names. Medications that act in similar ways often have similar generic names. The brand name is the name that each company that makes a specific drug call it, this is the one that is usually the clearest on the packaging.
A number of medications have been identified as safe to use in children that can assist to reduce symptoms associated with ASD and behavioural difficulties experienced by some children with developmental disabilities and/or other behavioural disorders such as ADHD. It s important to remember there are also many recognised and evidence based behavioural and psychological interventions that can reduce these symtoms as well. Each child is different and as such considering what interventions to use and which not to is a decision to bemade by the parents in consultation with professionals who can support the child as well as their primary health care provider.
Antipsychotic Medications
Antipsychotics such as risperidone, aripiprazole and haloperidol act primarily on the dopamine and serotonin systems, and are used in the treatment of ASD for a reduction in ‘challenging behaviours’ such as irritability, aggression and self-injurious behaviour.
Risperidone brand name: Risperdal, is an atypical antipsychotic and has been found to decrease irritability, agitation and crying; decrease hyperactivity/non-compliance; decrease repetitive behaviour; decrease social withdrawal; and improvements on Childhood Autism Rating Scale. However, there are associated adverse effects including weight gain; drowsiness; extrapyramidal symptoms including tremor, dyskinesia and rigidity amongst others .
Aripiprazole, brand names: Abilify, Aripiprex, has been found to decrease irritability, agitation and crying; decrease hyperactivity/non-compliance; and decrease repetitive behaviour and speech. Adverse effects include weight gain; drowsiness and sedation; extrapyramidal symptoms including tremor, dyskinesia and rigidity; and a decrease in prolactin levels
Haloperidol brand name Haldol; has been found to decrease irritability, aggression, withdrawal and hyperactivity. Adverse effects include constipation; nocturnal enuresis; difficulty sleeping; upper respiratory tract infection (URTI); sedation; and extrapyramidal symptoms including tremor, dyskinesia and rigidity. Haloperidol should only be used in children and adolescents under 18 who are under the care of a child psychiatrist
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs such as fluoxetine and citalopram act primarily on the serotonin system, and are used in the treatment of ASD for a reduction in repetitive and ‘challenging’ behaviours.
Fluoxetine brand name Prozac and Lovan, has been found to decrease repetitive behaviours. There were no significant adverse effects, however many children have had to have their dose reduced because of agitation
Fluvoxamine brand names Faverin, Fevarin, Floxyfral, Luvox, has been found to decrease repetitive behaviours; decrease maladaptive behaviours; decrease aggression; and improve language. However, adverse effects were commonly noted including nausea, mild sedation, insomnia, hyperactivity, agitation and aggression.
Citalopram brand names Celapram, Celica, Chemmart, has been found to have no significant difference in repetitive behaviour but some improvements in irritability, agitation and crying. Adverse effects include increased energy; impulsiveness; decreased concentration; hyperactivity; stereotypy; diarrhoea; decreased sleep; and dry and itchy skin
Psychostimulants
Psychostimulants such as methylphenidate, amphetamine and dextroamphetamine act primarily on the dopamine system, and are used in the treatment of ASD for a reduction in hyperactivity.
Methylphenidate brand names Concerta, Ritalin and GenRX has been found to decrease hyperactivity and non-compliance behaviours. Adverse effects include irritability; appetite and sleep changes; emotional lability; increased lethargy; anxiety; depression; social withdrawal; headaches; and diarrhoea.
This information has been gathered from research conducted in the area, if you wish to receive copies of the actual research please email us at admin@realtherapysolutions.com.au and we would be happy to share these with you.
Again please always consult with your Paeditrician or doctor before considering changes to medications for your child or to gain complete information about medications for your child.
