Medication - Psychotherapeutic

Some people consider medications before any other treatment, while others use them only as a last resort. Whichever approach you take, medications are available to help with attention span, panic attacks, hyperactivity, self-injurious behaviors, aggression, obsessive-compulsive disorders, sleeping disorders, and seizures. When neccessary medication should be used as part of an overall treatment plan that includes social, nutritional, educational and psychological treatment.

Antipsychotics

One of the primary classes of medications prescribed for Autism is the anti-psychotic. These medications help to control the typical aggressive behaviors seen in many children with Autism. While these medications are used to treat psychotic behaviors in psychiatric patients, they have also been shown to be effective with Autistics, but their use is not intended to imply that Autism and psychosis are in any way related. These medications cannot "cure", but they can eliminate or reduce many symptoms.

A number of anti-psychotic medications are available. Your child's doctor will determine which medication is the best for your child. Your job will be to report any and all side effects that could arise from use of the medication.

The medications in the category of anti-psychotic include:

• THORAZINE
• HALDOL
• CLOZARIL
• RISPERDAL

Risperdal (Risperidone) is probably the most common anti-psychotic in use. It can help to lessen aggression, agitation and explosive or compulsive behaviors. It has been well studied for use with Autism/PDD patients, and appears be effective. As with any medication, there can be side effects, but these are often minimal and include a sedative effect, weight gain, dizziness and muscular stiffness.

Stimulants

This is the category of medication used most often for individuals diagnosed with ADHD. Your physician may order these medications for your child if they have a comorbid attention disorder along with their diagnosis of autism. Stimulants affect how the brain controls impulses and regulates behavior and attention. They do this by influencing the availability of certain chemicals, called neurotransmitters, in the brain.

The medications in the category of stimulants include:

• Amphetamines (DEXEDRINE, ADDERALL)
• Methylphenidates (RITALIN, CONCERTA, BIPHENTIN)

Antidepressants

Antidepressants are used to treat moderate to severe depression. Although antidepressant medications don't cure depression, they can help you achieve remission - the disappearance or nearly complete reduction of symptoms. Symptoms of depression may include: Sadness, anxiety, depression-related sleep and appetite problems, concentration, and energy levels all can improve with antidepressant medications.

Precisely how antidepressants work to treat depression remains speculative. Scientists do know that antidepressants can influence brain activity through the effects they have on mood-related brain chemicals called neurotransmitters and certain nerve cell receptors. Nerve cells release neurotransmitters to communicate with other nerve cells in the brain. Neurotransmitters transmit signals across a gap (synapse) between the nerve cells.

Neurotransmitters associated with depression are serotonin (ser-oh-TOE-nin), norepinephrine (nor-ep-ih-NEF-rin) and possibly dopamine (DOE-puh-mene). Research suggests that people with depression have lower levels of one or more of these neurotransmitters.

The medications in the catagory of antidepressant in the serotonin reuptake inhibitors (SSRIs) category include:

• ZOLOFT (Sertraline)
• PROZAC (Fluoxetine)
• CELEXA (Citalopram)
• LUVOX (fluvoxamine)
• PAXIL (Paroxetine)

There are dozens of antidepressants available, each affecting neurotransmitters in a different way. We have choosen to list just one category of them. You and your Doctor will work togehter to find the right medication for you.

Obsessive-Compulsive Disorder Medications

There are two groups of medications that are effective in the treatment of obsessive-compulsive disorder. They are tricyclic antiobsessional antidepressant (ANAFRANIL) and serotonin reuptake inhibitors (SSRIs) like PROZAC, LUVOX, ZOLOFT, PAXIL, and CELEXA.

Antianxiety Medications (Anxiolytics)

Anxiolytics are drugs whose primary purpose is to relieve anxiety arising in normal life or in non-psychotic psychiatric disorders The term "minor tranquilizer" is sometimes used to describe the medications in this category. However, the word "minor" does not mean "mild." It actually means that physicians prescribe these medications to reduce less severe symptoms of psychological dysfunction.

The medications often prescribed for panic attacks include:

• VALlUM (diazepam) - often used for panis attacks
• ATIVAN (lorazepam) - often used for panis attacks

Sedative-Hypnotics

Sedative-hypnotics (sometimes called depressants) sedate, calm, or relax most individuals at low doses and, at somewhat higher doses, induce sleep. The hypnotic effect of the medication-induced sleep is very different from the phenomena associated with hypnosis. The confusion is because we once believed that hypnosis induced a sleep-like trance. However, we now know that hypnotized people are very much awake. Many medications in this class, such as MEBARAL, are effective in reducing seizure activity and may be termed anticonvulsants. Physicians can also use these medications as muscle relaxants, although muscle relaxation is secondary to their effects on the Central Nervous System.

The medications in the category of sedative-hypnotics include:

• AQUACHLORAL@ (chloral hydrate),
• ATARAXNISTARll.. (hydroxyzine)
• barbiturates (secobarbital, phenobarbital, and pentobarbital),
• BENADRYL@ (diphenhydramine), and PHENERG~ (promethazine).

Anti-epileptics

Another class of medications which appear to help control the aggressive behaviors is the anti-epileptic. It appears that these medications help to stabilize brain activity and therefore assist in the control of behaviors. Each of these medications requires regular blood testing in order to insure that liver or bone marrow damage does not occur. Since these medications are designed to treat seizure activity, they are often prescribed for the Autistic who suffers a seizure disorder as well, and their use provides the additional benefit of behavioral effects as well.

DEPAKOTE (Valproate) is the most common anti-epileptic used by physicians. It has the benefits of lessening explosive behaviors and aggression. Additionally, since many Autistic children suffer from seizure disorders it is considered to be one of the primary treatments for this condition as well. Most of the side effects such as a sedative effect and an upset stomach, do not pose severe problems. One side effect, however, must be very carefully monitored with blood tests. Research has shown that on rare occasions Depakote can cause liver damage. For this reason, close attention must be paid to the Depakote levels in the bloodstream and their effect on the liver.

Another anti-epileptic having the same benefit as Depakote is TEGRETOL (Carbamazapine), which can cause a rash and can cause bone marrow problems. The use of this medication requires the need for regular blood work.

Anti-Hypertensive medication

Surprisingly, one class of medications, the anti-hypertensive (high blood pressure) medications have shown promise as well in dealing with aggressive behaviors in Autistic children. Again, no one knows why these drugs seem to work, since the effects do not seem related to their blood pressure lowering qualities, but for some Autistic children they do seem to stem aggressiveness and emotional outbursts.

Of these INDEROL (Propranolol) and VISKEN (Pindolol) both seem to lessen aggression and explosions. Their side effects include a sedative effect, aggravation of asthmatic symptoms and light headedness or fainting due to the reduction of blood pressure. Because of this, the child should be observed closely and a physician consulted if the signs of blood pressure reduction appear.

Lithium had been another medication which was effective in dealing with explosive outbursts and agitation, but its side effects such as thyroid dysfunction have led many physicians to no longer use it. Lithium can also cause weight gain, stomach upset and frequent urination. Because of these side effects, it requires close monitoring with regular blood tests and cardiac testing.