Medication for Autism and ADHD
Parents of children and adolescents with co-occurring ASD and ADHD have reported high rates of medication use. 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 to help in the reduction of irritability and aggressive behavior. However, other medications can also be beneficial.
Antipsychotics
Research on co-occurring ADHD symptoms and ASD remains insufficient despite the growing interest. There are a variety of psychosocial treatment options that exist for each disorder, but few studies have characterized the effectiveness of treatment in the context of co-occurring symptoms. It is important to have a better understanding of the interaction between co-occurring disorders as well as how they change over time. This will aid in the development of both pharmacological and psychosocial approaches.
Many people with ASD also suffer from comorbid ADHD and other mental health issues such as depression or anxiety. These conditions can be treated with a variety of psychosocial therapies, such as cognitive behavior therapy (CBT), family therapy, and inter-personal therapy. These psychosocial treatments are more effective than pharmacological treatments for some people who have ADHD/ASD comorbidity.
Non-drug interventions are usually preferred for the most fundamental ASD symptoms, such as rigid thinking and poor social communication skills. These include peer support groups and behavioral training. In the case of comorbid ADHD and ASD symptoms like irritability, aggression, and disordered mood dysregulation, medications can be helpful. However the use of atypical antipsychotics has not been proven to reduce core ASD symptoms and the evidence supporting these medicines is limited at best.
Current theories suggest that the symptoms of autism spectrum disorders and ADHD are mediated by abnormalities in neurotransmitter signalling pathways, especially those that involve glutamate, dopamine and serotonin.2 These changes affect prefrontal cortex and mesocorticolimbic circuitry which are involved in the regulation of emotions and behavior control.3
Certain of these disorders could be caused by reduced brain activity in specific regions like the striatum. To treat ADHD and ASD, several drugs that regulate dopamine and glutamate levels are under investigation.
Different dopamine antagonists are being investigated in the treatment of co-occurring 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 waiting for dopamine-antagonists.
Antipsychotics are just like any other medication. The most current data on risperidone and aripiprazole in adults suffering from ASD and ADHD come from randomized controlled trials. These trials used parallel crossover and withdrawal plans. In general, these drugs are more effective than placebo in reducing irritability, aggression and enhancing function. They are also generally well tolerated. A third of patients who take these medications will find that the medication works well for most or all of their symptoms. The remaining two-thirds could only experience minor improvement.
Stimulants
Despite the fact that non-medicated treatment is usually recommended for autism, medication could be beneficial for certain adults and children. Antipsychotics can help reduce anxiety and self-injurious behavior and stimulants like methylphenidate (which helps with ADHD symptoms) can help improve concentration. These medications do not address the root of autism behaviors like repetitive and limited interest or difficulties communicating. Many people, both adults and children, with autism also suffer from mental health issues like depression, anxiety or mood disorders. These conditions can interfere with the daily functioning of a person.
Autism can also trigger irritability in children and adults. This can lead outbursts and self-injury as well as difficulty with routines or transitions. Atypical antipsychotics such as risperidone (Risperdal) and aripiprazole (Abilify) are the only medications approved to treat autism-related irritability. These drugs are believed to work by affecting the brain's dopamine system, which is involved in emotions as well as decision-making.
The most frequently prescribed ADHD medication are methylphenidate, like Ritalin and Ritalin, as well as mixed amphetamine salts that boost dopamine activity in the frontal lobe regions of the brain. adhd without medication suggest that these medications are as effective for patients with autism and ADHD as they are for those who have pure ADHD, though other studies suggest that they're not as helpful. It is important for parents to consult their physician about whether the benefits of these medications outweigh any possible side effects.
Some researchers believe that second-line ADHD medications such as atomoxetine or Guanfacine, could be more effective in reducing ADHD symptoms among people with autism. These medications are believed to be effective by interfacing with the dopamine and norepinephrine systems, which are associated with mood and motivation.
Connor's psychiatrist, as well as his behavioral therapists are striving to help him develop social skills and manage his anxiety. However, even with these treatments however, his hyperactivity and lack of attention can hinder the pace of his development. His family decided to give him an ADHD medication to help him concentrate.
After three months he is 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 that the medication has been an absolute lifesaver.
Benzodiazepines
The benzodiazepines comprise a category of drugs that slow down the central nervous system, resulting in tranquility and sleep. These are used to treat a broad range of ailments such as anxiety disorders, seizures, and insomnia. They target specific GABA receptors (gamma aminobutyric acid) which is a neurotransmitter that inhibits brainwaves and communication between neurons. By opening GABA receptors and keeping them open longer benzodiazepines enhance inhibition and prevent excitatory neurons from becoming overactive. The theory is that the characteristic autism-related behaviors are triggered by an imbalance in 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, a type of epilepsy.
Anxiety is often a co-occurring disorder among people with autism spectrum disorders. In some cases anxiety can be the reason behind an individual's aggressive or self-injurious behavior. In other cases, anxiety is a reaction to sensory issues which can make life difficult.
Treatment choices include antidepressants, which are believed to improve self-esteem and coping abilities by increasing the levels of the chemical norepinephrine in the brain. They also lower the reuptake of the neurotransmitters serotonin and norepinephrine, which helps reduce irritability and anxiety. Atypical antipsychotics, such as risperidone (Risperdal) and Aripiprazole (Abilify), can help with aggression, irritability and Tourette syndrome in people with autism.
Melatonin can enhance the quality and length of sleep for people with ASD. There aren't any controlled studies for this group. Methylphenidate is effective for treating ADHD symptoms in children with ASD however it's not as efficient as it is for typical children.
Medications for autism and ADHD could be harmful when they're not utilized properly. It's important to work with your doctor to find the appropriate dosage and medication for you child or teen. Always adhere to the instructions on the label of the medication. Do not abruptly stop or start taking your medication. This could be risky. If you suspect you or someone you know has taken too much medication, seek emergency help immediately. Keep track of your child's weight and height regularly and also their menstrual cycle, to ensure the medication isn't causing unwanted adverse side effects.
Medication Options
Both conditions are common in children with autism. Both are usually treated with medications. The most popular ADHD medications -- methylphenidate, amphetamines, atomoxetine, Strattera, and guanfacine can also be used to treat the hyperactivity and impulsivity of autism.
Certain children with autism exhibit severe aggression or irritability. These symptoms can be difficult for parents to manage with only methods for managing behavior. The use of medications like Abilify and Risperdal can reduce aggression and self-injury through the neurotransmitter dopamine. These medications have not been approved by the FDA for use with children with autism. However they are often prescribed off-label to treat specific symptoms.
It is important for parents to consult their pediatricians to determine if medication is appropriate for the child. Several studies show that kids who are on ADHD medications to treat autism coexisting with it may enjoy a better quality of life both at home and at school and can make significant academic and behavioral progress as well as social.
Psychiatrists have been trained to assist children suffering from the symptoms of ADHD and autism. They can provide behavior-oriented parental training that includes manuals and classes that teach parents how to manage disruptive behavior. They can also offer psychosocial services which focus on improving communication and relationships between the family members.
Some families, however, opt to use medication to manage their child's behavior. Some parents have found that antipsychotics have a calming effect on their child, which can reduce irritability and aggression.
In the same way, many children with autism also suffer from mental illness that interferes with their ability to learn and function, such as anxiety or depression. These disorders are frequently co-occurring and can affect the effectiveness of therapy. Combining cognitive behavior therapy with medication may be beneficial for children. This method is especially beneficial for children with severe autism or who do not respond to other interventions.