Medication for Autism and ADHD
Parents of children and adolescents who suffer from co-occurring ASD and ADHD report high rates of use of medication. However, research on psychopharmacological treatments is limited in both number and type.
Risperidone (Risperdal) and aripiprazole (Abilify) are the only drugs approved by the FDA to be used in children with autism to help reduce irritability and aggression. But some other drugs can also be beneficial.
Antipsychotics
Research on co-occurring ADHD symptoms and ASD is still insufficient, despite the increasing interest. There are many psychosocial treatment options for each disorder. However, only a few studies have assessed the effectiveness of these treatments in the context of co-existing symptoms. It is essential to understand the nature of the interactions between co-occurring disorders as well as how they develop over time. This will aid in the development of both pharmacological and psychosocial strategies.
Many people who suffer from ASD also suffer from the comorbidity of ADHD and other mental health issues such as anxiety or depression. There are a variety of psychosocial treatments available for these disorders, including cognitive behavioral therapy (CBT), interpersonal therapy, and family therapy. These psychosocial treatments are more effective than pharmaceutical treatments for those who suffer from ADHD/ASD comorbidity.
Non-drug treatments are typically the best option for core 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 like aggression, irritability, and disordered mood dysregulation, medications can be helpful. Atypical antipsychotics are not able to 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 that involve glutamate, dopamine and serotonin.2 This changes impact mesocorticolimbic and prefrontal cortex which is involved in emotional regulation and control of behavior.
Certain of these disorders could result from a reduction in brain activity in certain areas, such the striatum. To treat ADHD and ASD there are a variety of medications that alter dopamine or glutamate levels are being investigated.
Several types of dopamine antagonists are being studied in the treatment of comorbid ADHD and ASD symptoms and symptoms, including 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 pending for dopamine-antagonists.
As with adhd otc medication is not all patients respond similarly to antipsychotics. Randomized controlled trials provide the most reliable information about risperidone or aripiprazole for people with ASD or ADHD. These trials used crossover, parallel and withdrawal designs. In general, these medications are more effective than placebo at decreasing aggression, irritability and enhancing performance. They are also generally tolerated. However, one-third of those who use these medications will find that they work well for all or the majority of their symptoms, and the remaining two-thirds will experience only partial improvement.
Stimulants
Although non-medical care is typically recommended for autism, medication could be helpful for some adults and children. Antipsychotics can ease anxiety and self-injurious behaviors and stimulants like methylphenidate (which helps with ADHD symptoms) can help improve concentration. However, they don't address core autism behaviors like restricted and repetitive activities or difficulty communicating. Many people with autism also have co-occurring mental health issues like mood disorders, depression or anxiety that hinder daily functioning.
Irritability is another challenge for people with autism. It can cause anger outbursts, self-injury or difficulty in navigating routines or transitions. Atypical antipsychotics, such as risperidone (Risperdal) and aripiprazole (Abilify) are the only approved medications to treat autism-related irritability. The drugs are believed to work by altering dopamine, a brain organ involved in emotions and decisions.
The most frequently prescribed ADHD medication is methylphenidate like Ritalin, as well as mixed amphetamine salts that boost dopamine activity in the frontal lobes of the brain. Some studies suggest that these drugs are equally effective in treating those suffering from autism and ADHD than they are for those with pure ADHD. However other studies suggest they may not be as efficient. Whatever the case, it's crucial for parents to speak with their doctor about whether or the benefits outweigh any potential adverse effects of these drugs.
Some researchers believe that second-line ADHD medications such as Guanfacine and atomoxetine could be more effective in decreasing ADHD symptoms for those with autism. These drugs are believed work by interacting with the dopamine and norepinephrine systems, which are associated with mood and motivation.
Connor's psychiatrist, and behavioral therapists are working hard to help him improve his social skills and manage his anxiety. But even with these interventions however, his hyperactivity and lack of attention can hinder the progress of his improvement. So his family decided to test an ADHD medication to help him concentrate.
After three months, he's much more focused at school and in his daily activities. Parents can tell that he's more focused and listens to what other people say and participates in group activities. His mother says the medication is an absolute lifesaver.
Benzodiazepines
The benzodiazepines is a group of drugs that slows the central nervous system and produces sleepiness. They are utilized to treat a wide range of conditions that include anxiety disorders, seizures, and insomnia. They target specific receptors for the neurotransmitter GABA (gamma-aminobutyric acid), which inhibits brain waves and impedes communication between neurons. By opening GABA receptors and keeping them open longer benzodiazepines enhance inhibition and stop excitatory neurons from overactivating. The theory is that the defining characteristics of autism result from an imbalance between excitatory and inhibitory neurotransmissions in the brain. This theory is supported by animal models which demonstrate that clonazepam is able to reverse autistic behaviors in mice with Dravet Syndrome, which is a type of epilepsy.
Anxiety is often a co-occurring disorder for people suffering from autism spectrum disorders. In some cases anxiety can be the cause of aggressive or self-injurious behaviors. In other cases anxiety is a response to sensory issues which create difficulties.
Antidepressants are one of the treatments available. They boost the levels of norepinephrine, a chemical in the brain that is believed to boost self-esteem and coping. They also decrease reuptakes of neurotransmitters like norepinephrine, serotonin and dopamine. This helps to 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.
There is some evidence that melatonin can improve the duration and quality of sleep among adults with ASD. There aren't any controlled studies for this group. Methylphenidate is a good option for treating ADHD in children who have ASD. However, it's not nearly as effective in children who are normal-developing.
If they are not used correctly, the medication for autism and ADHD can be harmful. It is important to consult with your physician to find the right medication and dosage for your child or teen. Always follow the instructions on the label of the medication. Do not stop or change the dosage of your medication suddenly, as this can be extremely dangerous. You should seek immediate assistance in the event that you suspect you or someone else has taken too much medication. In addition, record your child's height and weight regularly and also their menstrual cycle, to ensure that the medications aren't causing any unwanted adverse effects.
Medication Options
Many kids with autism also suffer from ADHD and it's normal for these conditions to coexist. Treatment is often a part of the treatment plan for both. 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 impulsivity and hyperactivity associated with autism.
In addition, some children with autism are susceptible to extreme irritability and aggression and these symptoms can be difficult to manage using behavioral strategies alone. Abilify and Risperdal are medications that can reduce aggression as well as self-injury. They affect the neurotransmitter dopamine. These medications aren't endorsed by the FDA for use with children with autism, however they are sometimes prescribed "off-label" to treat specific symptoms.
It's important for parents to discuss with their pediatricians if medication is appropriate for their child. Many studies show that children who are taking ADHD medication to treat autism that coexists can have a better living conditions both at home and at school, and can make significant academic and behavioral progress.
Psychiatrists are trained in helping children deal with the symptoms of autism and ADHD. They can provide behavior-oriented parental training that includes manuals and classes for parents that teach them how to reduce disruptive behavior. They can also provide psychosocial treatment that focuses on improving communication and relationships between family members.
However, some families prefer to rely on medication to manage their child's behavior. Some parents have found that the antipsychotics' calming effects can help improve their child's anger, aggression and self-injury, and they may be inclined to look into this option if other treatments don't work.
In the same way, a lot of children with autism also suffer from mental illness that hinders their ability to function and learn, such as anxiety or depression. These conditions are often co-occurring and can affect therapy effectiveness. For these children that have a variety of disorders, a combination of therapy and medication could be beneficial. This approach is particularly helpful for children who suffer from an autism disorder that is more severe or who don't respond to other interventions.