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 drugs approved by the FDA for use in kids with autism to reduce aggression and irritability. Other drugs can be helpful.
Antipsychotics
While the interest in co-occurring ADHD and ASD symptoms has increased, research remains limited. There are adhd uk medication for each disorder. However, only a few studies have evaluated the effectiveness of these treatments when they are combined with other symptoms. Enhanced understanding of how co-occurring psychiatric disorders develop and interplay over time is crucial to inform both pharmacological and psychosocial approaches.
Many people with ASD have ADHD and other mental disorders like 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 pharmacological therapies for those who suffer from ASD/ADHD comorbidity.
Non-drug treatments are typically the best option to treat the core ASD symptoms, like rigid thinking and poor social communication skills. These include peer support groups as well as behavioral training. Medicines can be beneficial for comorbid ADHD/ASD symptoms such as irritability, aggression, or mood dysregulation. Atypical antipsychotics are not able to improve the core ASD symptoms and the evidence is at best limited.
Current hypotheses suggest that symptoms of autism spectrum disorders and ADHD are caused by dysfunctions in neurotransmitter signalling pathways, particularly those that involve glutamate, dopamine, and serotonin.2 These changes impact on prefrontal cortex and mesocorticolimbic circuitry, which are involved in the regulation of emotions and behavior control.3
These abnormalities could be due to a decrease in brain activity in certain regions, such the striatum. To treat ADHD and ASD there are a variety of medications that modulate dopamine or glutamate levels are under investigation.
Dopamine antagonists of various types are being investigated for the treatment of comorbid 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). The emergence of a common nomenclature for dopamine antagonists is still in the works.
As with all medication it is not all patients respond similarly to antipsychotics. Randomized controlled trials offer the best data on the effects of aripiprazole or risperidone on people with ASD or ADHD. adhd medication employed parallel crossover and withdrawal strategies. In general, the drugs perform better than placebo in reducing aggression and irritability and improving functioning. They are also generally tolerated. A third of patients who take these drugs will find that the medication works well for most or all of their symptoms. The remaining two-thirds of patients may only experience minor improvement.
Stimulants
Although non-medical care is not typically recommended for autism, medication may be helpful for some adults and children. Antipsychotics, for instance, help to ease anxiety and reduce self-injurious behaviors and stimulants such as methylphenidate, which helps with ADHD symptoms, can enhance the ability to focus. The medication does not address the core autism behaviors like repetitive or limited interest or difficulties in communicating. Many people with autism also have co-occurring mental health conditions like depression, mood disorders, or anxiety that interfere with everyday functioning.
Irritability can be a major issue for children and adults with autism. It can cause outbursts and self-injury, and difficulties with routines or transitions. Atypical antipsychotics such as risperidone (Risperdal) and Aripiprazole (Abilify) are the only drugs that have been approved to treat autism-related irritability. They 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 mixed amphetamine salts that boost dopamine activity in the frontal lobes of our brain. Certain studies suggest that these medications are as effective in patients with autism and ADHD as they are for those who have pure ADHD However, other studies indicate that they are less helpful. Parents should consult their physician about whether the benefits of these drugs outweigh any potential side effects.
Some researchers believe that second-line ADHD medications such as Guanfacine and atomoxetine may be more helpful in the reduction of ADHD symptoms for people with autism. These drugs are believed to be effective by interfacing with the dopamine and norepinephrine systems, which are connected with motivation and mood.
The psychiatrist and a behavioral therapist, are working hard to help him improve his social skills and manage his anxiety. However, even with these treatments, the hyperactivity and inattention can get in the way of his progress. His family decided to give him an ADHD medication in order 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, listens to what others speak and participates in group activities. His mother says the medication has been an absolute lifesaver.
Benzodiazepines
The benzodiazepines is a group of drugs which slows the central nervous system and induces sleepiness. These are used to treat a wide range of conditions, including anxiety disorders, seizures, and insomnia. They target specific receptors for the neurotransmitter GABA (gamma-aminobutyric acid) which blocks brain waves and inhibits communication between neurons. By keeping GABA receptors open longer and allowing them to open more, benzodiazepines increase inhibition and stop the overactivity of excitatory neurons. The theory suggests that the hallmark features of autism are caused by an imbalance in inhibitory and excitatory neurotransmissions in the brain. This theory is backed by animal models which demonstrate that clonazepam reverses certain autism-related behaviors in mice suffering from Dravet Syndrome, which is a type of epilepsy.
Anxiety is often a comorbid disorder in people with autism spectrum disorders. In some cases anxiety is the cause of self-injurious or aggressive behaviors. In other instances, anxiety is a reaction to sensory issues that can make life difficult.
Antidepressants are among the treatments available. They increase the amount of norepinephrine, a chemical in the brain that is believed to boost self-esteem and coping. They also decrease the reuptake of neurotransmitters, such as serotonin, dopamine and norepinephrine. This helps to reduce anxiety and irritability. Atypical antipsychotics like risperidone and aripiprazole are able to aid people suffering from autism, aggression, irritability, and Tourette syndrome.
There is evidence that melatonin may increase the duration and quality of sleep among adults suffering from ASD. However, controlled studies are lacking in this population. Methylphenidate is a good option for treating ADHD in children who have ASD. However it's not as effective in children who are normal-developing.
The medications for autism and ADHD can be dangerous when not used correctly. It is important to consult with your doctor to determine the appropriate dosage and medication for your child or teenager. Always follow the directions on the label of the medication. Do not stop or begin taking your medications suddenly, which could be very dangerous. If you suspect you or someone you know has taken too much, seek emergency help immediately. Record your child's weight and height on a regular basis as well as their menstrual cycle, to ensure that the medication doesn't cause unwanted side effects.
Medication Options
Both of these conditions are common among children with autism. Medication is often part of the treatment plan for both. The most common ADHD medications - methylphenidate, amphetamines, atomoxetine, Strattera, and guanfacine are also used to treat the impulsivity and hyperactivity of autism.
Additionally, some children with autism are prone to severe irritability and aggression and these symptoms are difficult to manage with behavioral strategies alone. Medications like Abilify and Risperdal can help reduce aggressiveness, irritability and self-injury by affecting a neurotransmitter called dopamine. These medications are not approved by the FDA for use with children with autism. However, they are sometimes prescribed 'off-label' to treat specific symptoms.
It is crucial parents talk to their pediatricians if the medication is suitable for their child. Several studies show that kids who are taking ADHD medications to treat autism coexisting with it have a better quality of life at home and at school, and make significant academic, behavioral and social progress.
Psychiatrists are trained in helping children manage symptoms of autism and ADHD. They can suggest behavior-based parent training that includes manuals and group-based courses that teach parents how to reduce disruptive behavior. They also offer psychosocial treatment that focuses on improving communication and relationships between family members.
However, some families prefer to rely on medication to control their child's behavior. Some parents have discovered that the antipsychotics' calming effects can help reduce the child's aggression, anger and self-injury, and may be inclined to look into this option when other therapies do not work.
In the same way as many children with autism also suffer from a mental health condition that hinders their ability to learn and function, for example depression or anxiety. These disorders often co-occur and can interfere with the effectiveness of therapy. Combining cognitive behavioral therapy with medication can be beneficial for these children. This approach is especially helpful for children who have a more severe form autism, or those who do not respond to other therapies.