Medication for Autism and ADHD
Parents of children with ASD/ADHD that co-occur have reported 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 drugs approved by the FDA to be used in children with autism to reduce aggression and irritability. Other drugs can be helpful.
Antipsychotics
While interest in co-occurring ADHD and ASD symptoms has risen but research remains insufficient. A variety of psychosocial therapies are available for each disorder, however, very few studies have assessed treatment effectiveness in the context of co-occurring symptoms. Enhanced understanding of how co-occurring disorders develop and interact over time will be important for informing both pharmacological and psychosocial strategies.
Many people with ASD have ADHD as well as other mental illnesses such as depression or anxiety. These conditions can be treated with various psychosocial therapies, including cognitive behavior therapy (CBT), family therapy, and interpersonal therapy. These psychosocial treatments could be more effective than medication for those suffering from co-occurring ADHD and ASD.
For the core ASD symptoms, such as poor social communication skills and rigid thinking, non-pharmacological interventions are usually preferred. These include peer support groups as well as behavioral training. The use of medication can help with ASD symptoms that are comorbid with ADHD, such as irritability and aggression, or mood dysregulation. However the use of atypical antipsychotics has not been proven to reduce the fundamental ASD symptoms and the evidence for these medications is sporadic at best.
Current theories suggest that the symptoms of autism spectrum disorders and ADHD are caused by alterations in neurotransmitter signalling pathways, especially those that involve glutamate, dopamine and serotonin.2 These changes affect mesocorticolimbic and prefrontal cortex which are involved in emotional regulation and behaviour control.3
Some of these abnormalities may result from a reduction in brain activity in specific regions, such the striatum. Therefore, a variety of drugs that are believed to modulate dopamine and glutamate are being studied for use in the management of ADHD and ASD comorbidities.
Different dopamine antagonists are being studied in the treatment of the comorbid ADHD and ASD symptoms and symptoms, including risperidone (Risperdal, Janssen Pharmaceutical Inc.; Titusville, NJ) as well as aripiprazole (Abilify, Otsuka America Pharmaceutical Inc.; Rockville, MD) and domperidone (Motilium, Johnson & Johnson; New Brunswick, NJ). The development of a consensus label for dopamine antagonists is still in the works.
As with all medications it is not all patients respond the same to antipsychotics. Randomized controlled trials offer the best data on risperidone or aripiprazole for people with ASD or ADHD. These trials used parallel crossover and withdrawal strategies. In general, these medications are more effective than placebo in reducing irritability, aggression and enhancing function. The drugs are generally well-tolerated. One third of people who take these drugs will find that the medication works well for most or all of their symptoms. The other two-thirds may only see partial improvement.
Stimulants
Although non-medical care is typically recommended for autism, medication could be beneficial for a few children and adults. Antipsychotics can reduce anxiety and self-injurious behaviors and stimulants like methylphenidate (which aids in reducing ADHD symptoms) can improve concentration. However, these medications do not treat the core autism-related behaviors like repetitive and limited interests or difficulties communicating. Many people, both adults and children, who are autistic also suffer from mental health issues like depression, anxiety or mood disorders. These conditions can affect with the daily functioning of a person.
Autism can also trigger irritability in children and adults. It can result in outbursts, self-injury and difficulty with transitions or adhering to routines. Atypical antipsychotics such as risperidone (Risperdal) and aripiprazole (Abilify) are the only medications approved for treating autism-related irritation. They are believed to work by affecting the brain's dopamine receptor, which is involved in emotions as well as decision-making.
Most commonly prescribed ADHD medication is methylphenidate, like Ritalin. It also contains mixed amphetamines salts which boost dopamine levels in the frontal brain lobes. Some studies suggest that these drugs are equally effective in treating patients with autism and ADHD than they are for people with pure ADHD. However some studies suggest they may be less efficient. Regardless, it's important for parents to consult their doctor to determine whether or the benefits outweigh any possible side effects from these drugs.
Some researchers believe that second-line ADHD medications like Guanfacine and atomoxetine may be more helpful in reducing ADHD symptoms for those with autism. These drugs are believed to work by interacting with the norepinephrine and dopamine systems, which are linked with motivation and mood.
The psychiatrist and a the therapist for behavioral issues, are trying to help him improve his social skills and deal with his anxiety. Even with these interventions hyperactivity and inattention can continue to hinder his progress. So, his family decided to take an ADHD medication to help him focus.
After three months he is more focused at school and in his daily activities. Parents are noticing that he's able to follow instructions better, pay attention when someone speaks to him and take part in group activities. His mother says the medication has been a lifesaver.
Benzodiazepines
The benzodiazepines are a class of drugs that slows down the central nervous system and produces sleepiness. They are utilized to treat a wide variety of ailments, including anxiety disorders, seizures, and insomnia. They target specific GABA receptors (gamma aminobutyric acid) which is a neurotransmitter that hinders brainwaves and communications between neurons. By opening GABA receptors and keeping them open longer, benzodiazepines boost inhibition and stop excitatory neurons from becoming hyperactive. The theory is that the hallmark characteristics of autism are caused by an imbalance between excitatory and inhibitory neurotransmissions in the brain. This theory is supported by animal models that show that clonazepam is able to reverse autism-related behaviors in mice suffering from Dravet Syndrome, which is a type of epilepsy.
Anxiety is a typical comorbid condition in people with autism spectrum disorders. In linked website is the cause of aggressive or self-injurious behaviors. In other instances anxiety is a reaction to sensory issues which can make life difficult.
Treatment alternatives include antidepressants that are believed to improve self-esteem and coping abilities by increasing the level of the chemical norepinephrine within the brain. They also decrease reuptakes of neurotransmitters such as serotonin, norepinephrine and dopamine. This reduces irritability and anxiety. Atypical antipsychotics, like risperidone (Risperdal) and aripiprazole (Abilify), can help with irritability, aggression, and Tourette syndrome in people who have autism.
Melatonin can improve the quality and duration of sleep for people with ASD. However, studies that have been controlled aren't found in this population. Methylphenidate has proven effective in treating ADHD symptoms in children suffering from ASD however, it's not as efficient as it is for typically developing kids.
Medications for autism and ADHD could be harmful when not used correctly. The most important thing is to work with your doctor to find the best dosage and medication for your child or teen. Always follow the directions on the label of the medication. Do not abruptly stop or commence taking your medication. This can be dangerous. It is important to seek immediate help when you suspect that you or someone else has taken too much medication. Record your child's weight and height on a regular basis and also their menstrual cycle, to ensure the medication isn't causing unwanted adverse effects.
Medication Options
Both conditions are common in children with autism. Both conditions are often treated with medications. The most commonly used ADHD medications - methylphenidate, amphetamines, atomoxetine, Strattera, and guanfacine can also be used to treat the impulsivity and hyperactivity of autism.
In addition, certain children with autism are prone to severe irritability and aggression and these symptoms can be difficult to manage using methods for managing behavior on their own. Certain medications such as Abilify and Risperdal can reduce aggression, 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 sometimes prescribed 'off-label' for specific symptoms.
It is important for parents to discuss with their pediatricians whether medication is suitable for their child. Many studies show that children who take ADHD medication to treat Autism can have a better quality of life both at home and in school, and can make significant academic and behavioral progress.
Psychiatrists are trained in helping children deal with the symptoms of autism and ADHD. They may recommend behaviorally focused parent training, which includes groups and manual programs that help parents develop skills to reduce disruptive behaviors. They can also provide psychosocial services which focus on improving communication and relationships between the family members.
However, some families prefer using 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.
In the same way, many children with autism also suffer from mental illness that affects their ability to learn and function like depression or anxiety. These disorders are often co-occurring and can affect the effectiveness of therapy. Combining cognitive behavior therapy with medication could be beneficial for children with these disorders. This approach is particularly helpful for children with an extreme form of autism or who don't respond to other therapies.