Medication for Autism and ADHD
Parents of children who have ASD/ADHD that co-occur have reported high rates of use of medications. However, research on psychopharmacological treatments is limited in both number and type.
Risperidone (Risperdal) and Aripiprazole (Abilify) are the only medications approved by the FDA for use in kids with autism to reduce aggression and irritability. Other medications can be beneficial.
Antipsychotics
Research on co-occurring ADHD symptoms and ASD is still insufficient, despite the growing interest. 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. It is important to understand the nature of the interaction between co-occurring disorders and how they change over time. This will aid in the development of both pharmacological as well as psychosocial strategies.
Many people suffering from ASD have ADHD and other mental disorders such as anxiety or depression. These conditions are treated with a variety of psychosocial therapies, such as cognitive behavior therapy (CBT) as well as family therapy, and inter-personal therapy. These psychosocial treatments may be more effective than pharmacological treatments for some people with the comorbidity of ADHD and ASD.
Non-drug treatments are typically the best option for the most fundamental ASD symptoms, including rigid thinking and a lack of social communication skills. These include behavioral training as well as peer support groups. The use of medication can help with comorbid ADHD/ASD symptoms like irritability and aggression, or disruptive mood dysregulation. Atypical antipsychotics do not improve core ASD symptoms and the evidence is at best weak.
Current hypotheses suggest that symptoms of autism spectrum disorders and ADHD are mediated by abnormalities in neurotransmitter signalling pathways, especially those that involve dopamine, glutamate, and serotonin.2 These changes affect prefrontal cortex and mesocorticolimbic circuitry which are involved in emotional regulation and behavior control.3
A few of these issues are believed to be caused by reduced activity in certain brain regions, such as the striatum. To treat ADHD and ASD there are a variety of drugs that regulate dopamine and glutamate levels are being investigated.
Several types of dopamine antagonists are being studied in the treatment of co-occurring ADHD and ASD 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 nomenclature is waiting for dopamine-antagonists.
Antipsychotics are the same as any other medication. Randomized controlled trials provide the most accurate information on the use of aripiprazole or risperidone for people with ASD or ADHD. These trials used parallel crossover and withdrawal plans. In general, the drugs perform better than placebo in reducing irritability and aggression and enhancing functioning. They are also generally tolerated. However, one-third of individuals who take these medicines will find that they work well for all or a majority of their symptoms, and the remaining two-thirds of them will see only a slight improvement.
Stimulants
Although non-medical care is typically recommended for autism, medication could be beneficial for certain children and adults. Antipsychotic medications help to ease anxiety and reduce self-injurious behaviors; and stimulants like methylphenidate, which aids in the treatment of ADHD symptoms, can enhance the ability to focus. However, medications don't address core autism behaviors such as repetitive and restricted activities or difficulty communicating. Many children and adults who have autism also suffer from mental health disorders like anxiety, depression, or mood disorders. These conditions can interfere with daily functioning.
Autism can also trigger anger in adults and children. It can result in outbursts, self-injury and difficulty with transitions or adhering to routines. Atypical antipsychotics like risperidone (Risperdal) and Aripiprazole (Abilify) are the only medications approved to treat autism-related anger. These drugs are believed to work by affecting the brain's dopamine system, which is involved in emotions and decision-making.
The most frequently prescribed ADHD medication is methylphenidate like Ritalin. It also contains mixed amphetamines, which increase dopamine levels in the frontal regions of the brain. Certain studies suggest that these medications are as effective for patients with autism and ADHD as they are in those who have pure ADHD however other studies indicate that they may be less helpful. Whatever the case, it's crucial for parents to speak with their doctor about whether or whether the benefits outweigh the possible side effects from these medications.
Some researchers believe that second-line ADHD medication like Guanfacine and atomoxetine may be more helpful in decreasing ADHD symptoms for those with autism. These medications are believed to work by interacting with the dopamine and norepinephrine systems, which are linked with motivation and mood.
The therapist and psychiatrist for Connor are trying to teach him social skills and help him manage his anxiety. But even with these interventions, the hyperactivity and inattention can hinder the pace of his development. His family decided to give him an ADHD medication in order to help him focus.
After adhd anxiety medication is more focused in school and his daily activities. Parents can tell that he is more attentive, listens to what others speak and participates in group activities. His mother says that the medication has been an absolute lifesaver.
Benzodiazepines
The benzodiazepines are a group of drugs that slow the central nervous system, resulting in sleepiness and a calm mood. These are used to treat a wide variety of ailments, including anxiety disorders, seizures, and insomnia. They target specific receptors for the neurotransmitter GABA (gamma-aminobutyric acid) which inhibits brain waves and blocks communication between neurons. By keeping GABA receptors open for longer and allowing them to open more the benzodiazepines improve inhibition and prevent excitatory neuron overactivity. The theory is that the hallmark traits of autism are due to an imbalance in excitatory and inhibitory neurotransmissions in the brain. This hypothesis is supported by animal models which demonstrate that clonazepam can reverse certain autistic behavior in mice with Dravet Syndrome, which is a type of epilepsy.
Anxiety is a common co-occurring condition among people with autism spectrum disorders. In some instances, anxiety is the motivation behind a person's aggressive or self-injurious behavior. In other cases anxiety is a response to sensory issues that can make life difficult.
Antidepressants are among the treatments available. They increase the amount of norepinephrine, which is a chemical found in the brain that is thought to improve coping and self-esteem. They also reduce reuptakes of neurotransmitters like 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 those with autism.
Melatonin may improve the quality and duration of sleep for adults with ASD. There aren't any studies that have been conducted for this group. Methylphenidate has proven effective in treating ADHD symptoms in children suffering from ASD however, it's not as efficient as it is for generally developing children.
If they are not utilized correctly, medications for autism and ADHD could be harmful. It's crucial to work with your physician to find the appropriate dosage and medication for your child or teenager. Always follow the instructions on the medication label. Don't discontinue or start taking your medication suddenly, as this can be extremely dangerous. It is important to seek immediate help if you suspect that you or someone else has taken too much medication. Keep track of your child's weight and height regularly as well as their menstrual cycle to make sure that the medication doesn't cause unwanted side effects.
Medication Options
Many kids with autism also have ADHD and it's not uncommon for both conditions to coexist. Both conditions are often treated with medication. The most common ADHD medications -- methylphenidate, amphetamines, atomoxetine, Strattera, and guanfacine can also be used to treat the impulsivity and hyperactivity of autism.
Additionally, some children with autism are susceptible to severe aggression and irritability and these symptoms are difficult to manage using behavior strategies on their own. Abilify and Risperdal are medications that 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, but they are sometimes prescribed "off-label" to treat specific symptoms.
It's important parents talk to their pediatricians whether medication is suitable for their child. Numerous studies have shown that children who take ADHD medication to treat Autism can have better living conditions both at home and at school, and can make significant academic and behavioral progress.
Psychiatrists are trained to assist children who suffer from the symptoms of ADHD and autism. They can recommend behavior-oriented parent training that involves manuals and classes for parents that teach them how to manage disruptive behavior. They can also provide psychosocial treatment that focuses on improving communication and relationships among family members.
Some families, however, prefer to rely on medication to control their child's behavior. Some parents have found that the calming effects of antipsychotics can aid in reducing the child's aggression, anger as well as self-injury. They may be willing to consider this option when other therapies aren't working.
Similar to the above, many children who have autism also suffer from a mental health condition that affects their ability to learn and function, such as depression or anxiety. These conditions are often co-occurring and can interfere with the effectiveness of therapy. For these children, a combination of cognitive therapy and medication could be helpful. This approach is particularly helpful for kids who have a more severe autism disorder or those who do not respond to other treatments.