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Medication for Autism and ADHD

Parents of children with ASD/ADHD that co-occur have reported high rates of use of medications. However, types of adhd medication on psychopharmacological treatments is limited in both number and type.

Risperidone and aripiprazole are called Risperdal and Abilify, are the only medications that have been approved by the FDA to be used by children with autism to help in the reduction of irritability and aggressive behavior. Other drugs may be beneficial.

Antipsychotics

While the interest in co-occurring ADHD and ASD symptoms has grown but research remains insufficient. A variety of psychosocial therapies are available for each disorder, but few studies have characterized the effectiveness of treatment in the context of co-occurring symptoms. It is important to understand the nature of the interplay between co-occurring disorders as well as how they develop over time. This will aid in the development of both pharmacological as well as psychosocial approaches.

Many people with ASD suffer from ADHD and other mental conditions such as depression or anxiety. There are a variety of psychosocial treatments available for these disorders, including cognitive behavioral therapy (CBT) and interpersonal therapy and family therapy. These psychosocial treatments are more effective than pharmacological therapies for some people who have ASD/ADHD comorbidity.

For core ASD symptoms like low social skills and rigid thinking, non-pharmacological interventions are typically preferred. These include behavioral training as well as peer support groups. In the case of comorbid ADHD and ASD symptoms like aggression, irritability and disordered mood dysregulation, medications can be helpful. However the use of atypical antipsychotics has not been proven to help improve core ASD symptoms and the evidence for these medicines is limited at best.

Current theories suggest that the symptoms of autism spectrum disorders (ASD) and ADHD are caused by alterations in neurotransmitter pathways, particularly ones 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 are believed to be caused by reduced activity in specific brain regions, including the striatum. Therefore, a number of medications that are known to regulate dopamine and glutamate are being investigated to help in the treatment of ADHD and ASD comorbidities.

Different types are being studied for the treatment of the comorbid ADHD symptoms and ASD and ASD, including risperidone, aripiprazole, and domperidone. A consensus nomenclature is waiting for dopamine-antagonists.

Antipsychotics are just like any other medication. The most reliable data available on aripiprazole and risperidone in adults with ASD and ADHD come from randomized controlled trials. These trials employed parallel crossover and withdrawal designs. In general, these medications are more effective than placebo at reducing irritability, aggression and improving function. The drugs are generally well-tolerated. A third of patients who use these medications will find that the medication is effective for the majority or all of their symptoms. The remaining two-thirds of patients may only experience a slight improvement.

Stimulants

Although non-medical care is typically recommended for autism, medication could be helpful for some children and adults. Antipsychotics, for instance, can ease anxiety and reduce self-injurious behaviors and stimulants such as methylphenidate that help with ADHD symptoms, can enhance the ability to concentrate. Medication does not address core autism behaviors like repetitive and limited interest or difficulties communicating. Many children and adults who are autistic also suffer from mental health issues such as anxiety, depression or mood disorders. These conditions can affect with the daily functioning of a person.

Autism can also trigger anger in adults and children. This can lead to anger outbursts, self-injury or difficulty with transitions or following routines. Atypical antipsychotics like risperidone (Risperdal) and Aripiprazole (Abilify) are the only approved medications for treating autism-related irritability. They are believed to affect the brain's dopamine system which is involved in emotions as well as decision-making.

The most frequently prescribed ADHD medication is methylphenidate, like Ritalin. It also contains mixed amphetamines salts which increase dopamine levels in the frontal brain lobes. 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 suggest that they are less beneficial. Whatever the case, it's crucial for parents to talk with their doctor to determine whether or not the benefits outweigh possible side effects from these medications.

Some researchers believe that second-line ADHD medications like Guanfacine and atomoxetine may be more effective in decreasing ADHD symptoms in people with autism. These medications are believed to function by interfering with the dopamine-norepinephrine axis, which is associated with motivation and mood.


Connor's psychiatrist and behavioral therapist are working hard to help him develop social skills and help him cope with his anxieties. Despite these efforts hyperactivity and inattention could still hinder his progress. So, his family decided to try an ADHD medication to help him focus.

After three months, he's much more focused at school and in his daily activities. Parents are noticing that he's able to follow instructions better, listen when someone speaks to him, and participate in group activities. His mother says the medication is an absolute lifesaver.

Benzodiazepines

The benzodiazepines are a class of drugs that slows the central nervous system and causes sleepiness. They 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 inhibits brain waves and blocks communication between neurons. By opening GABA receptors and keeping them open longer benzodiazepines enhance inhibition and prevent excitatory neurons from overactivating. The idea is that the typical autism behaviors are caused by an imbalance in excitatory and inhibitory neurotransmissions in the brain. Animal models support this theory, showing that clonazepam reverses some of the autistic behaviors observed in mice with Dravet syndrome, which is a type of epilepsy.

Anxiety is a common comorbid condition in people with autism spectrum disorder. In some cases, anxiety is the cause of aggressive or self-injurious behaviors. In other instances it's due to sensory issues that cause difficulty and can trigger anxiety.

Treatment choices include antidepressants, which are believed to enhance coping skills and self-esteem by increasing the level of the chemical norepinephrine that is found in the brain. They also decrease reuptakes of neurotransmitters like serotonin, norepinephrine and dopamine. This can help reduce anxiety and irritability. Atypical antipsychotics, such as risperidone (Risperdal) and Aripiprazole (Abilify), can help with aggression, irritability and Tourette syndrome in people who have autism.

Melatonin can improve the quality and duration of sleep for adults suffering from ASD. However, studies that have been controlled are lacking in this population. Methylphenidate is effective for treating ADHD symptoms in children who have ASD, but it's not as efficient as it is for generally developing children.

The medications for autism and ADHD can be dangerous when not used correctly. It is important to consult with your physician to find the right medication and dosage for your child or teenager. Always follow the directions on the label of the medication. Do not stop or change the dosage of your medication abruptly, as it could be very dangerous. You should seek immediate help in the event that you suspect 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 side effects.

Medication Options

Many children with autism have ADHD and it's normal for these conditions to coexist. Both conditions are often treated with medication. The drugs that are frequently used to treat ADHD -- methylphenidate (Ritalin), amphetamines (Adderall, Vyvanse), atomoxetine (Strattera) and Guanfacine (Intuniv, Tenex) -- can be effective in treating the hyperactivity and impulsivity that is associated with autism.

In addition, some children with autism are susceptible to severe irritability and aggression and these signs can be difficult to manage with behavior strategies on their own. Abilify and Risperdal are medications that decrease aggression as well as self-injury. They work by affecting the neurotransmitter dopamine. These medications are not approved by the FDA for use with children with autism, but they are often prescribed "off-label" to treat specific symptoms.

It's important for parents to discuss with their pediatricians if medication is suitable for their child. Several studies show that kids who are on ADHD medications for coexisting autism may enjoy a better quality of life at home and at school and can make significant academic and social, as well as behavioral, progress.

Psychiatrists are trained in helping children manage symptoms of autism and ADHD. They can suggest behaviorally-oriented parent training, which includes manual and group-based programs that teach parents how to manage disruptive behavior. They can also provide psychosocial treatment that focuses on improving communication and relationships among family members.

Certain families, however, prefer to use medication to control their child's behavior. Parents have reported that the antipsychotics' calming effects can aid in reducing the child's aggression, anger and self-injury, and they might be willing to consider this option if other treatments don't work.

In the same way, a lot of children with autism also suffer from mental illness that interferes with their ability to learn and function, such as anxiety or depression. These disorders often co-occur and may affect the effectiveness of therapy. For these children using a combination of cognitive therapy and medication could be beneficial. This approach is particularly helpful for kids who have severe autism or who don't respond to other interventions.

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