Medication For Autism and ADHD
Many people with autism suffer from ADHD, and medication for ADHD can be helpful in reducing the overlapping autism symptoms, such as hyperactivity and the tendency to be impulsive. But medications can have side effects.
Research is needed to know how co-occurring symptom trajectories affect the outcome of treatment. adhd medications for adults like methylphenidate (Ritalin) generally treat ADHD and may help with autism-related symptoms that are overlapping as well as some anticonvulsant drugs.
Medicines for Inattention
Autism and attention deficit/hyperactivity disorder (ADHD), are disorders that coexist. It is estimated that between 30 and 50% of those diagnosed with autism exhibit an elevated level of ADHD symptoms. This co-occurrence is both relevant clinically and epidemiologically since effective treatment of the primary symptoms of both disorders improves adaptive functioning and helps prevent negative coping behaviors [1 2, 3].
Inattention, impulsivity and hyperactivity are all signs of ADHD. Medications used for the treatment of ADHD generally reduce the symptoms and can help to improve social, academic, and behavioral outcomes in people with coexisting autism and ADHD.
In a longitudinal cohort study, researchers found that the proportion of individuals prescribed psychotropic drugs was similar in individuals with and without coexisting autism. However, the medication class and prescription frequency differed between the groups. The most commonly prescribed medication was stimulant. Atomoxetine and antipsychotics and SSRIs were then prescribed. In a study of subgroups, children with ADHD and autism were more likely than those who are ADHD-Inattentive ADHD medication.
Stimulants work by increasing the levels of dopamine and norepinephrine in your brain which are neurotransmitters that are associated with motivation as well as reward, decision-making and emotional. Numerous studies have proven that stimulant medications are effective in decreasing ADHD symptoms in children who have autism and ADHD However, some suffer from side effects such as stomach problems, headaches, insomnia, and a decrease in appetite.
Nonstimulant drugs, such as Guanfacine and atomoxetine appear to decrease ADHD symptoms in children who suffer from autism and ADHD. A few studies suggest that the atypical antipsychotics such as aripiprazole or risperidone could reduce irritability in children with ASD. However, more research is required to determine if this is due to a reduction in ADHD symptoms or a change in core ASD behaviors.
An understanding of the co-occurring symptoms patterns can assist clinicians to optimize the timing and duration of psychosocial and pharmacological treatment for each disorder, and to identify the crucial times during which interventions are more effective. A better understanding of co-occurring symptom patterns and how they interact over time will help identify optimal treatment interventions to mitigate the negative effects of ADHD symptoms on ASD fundamental functions.
Medicines for Hyperactivity
Although few research studies have compared psychopharmacological treatment for coexisting ADHD and autism, available data suggests that individuals with both conditions may benefit from optimal use of medication. Several clinical trials indicate that stimulant drugs (methylphenidate and atomoxetine) help to improve the primary ADHD symptoms in children and adolescents with ASD.
The same drugs have been proven to enhance social skills in people with autism. These medications aren't risk-free and should only ever be prescribed by a medical professional who is knowledgeable about the risks and benefits of each drug. Additionally, individuals with autism tend to react differently to each medication and certain medications may be harmful in certain situations.
A large-scale study on the population found that two-thirds of children between the ages of 6 and 11 and three quarters of youth between the ages of 12 and 17 with co-occurring ADHD and autism were taking some form of psychotropic medication. Similar to the prevalence of psychiatric drugs used by children and youths with ADHD on their own. The comorbid diagnosis of schizophrenia, intellectual disability and OCD were more common among those who suffer from ADHD and ASD as compared to people with ADHD alone.
This study also found that individuals with coexisting ADHD and ASD were less likely to start and continue continuous psychopharmacological treatment than those with ADHD alone. This is due to the higher rate of discontinuation among ASD patients due to side reactions like irritability or difficulty tolerating methylphenidate doses.
Comorbid ADHD and Autism are associated with more impairments than either condition on its own. Therefore, it is important to improve the treatment of both disorders. Research should focus on finding the most effective psychosocial treatment for coexisting ADHD and autism. These include behavior therapies as well as parent education and social skills training. These are known to reduce ADHD and autism-related disruptions. Future research should also look at developmental trajectories of the co-existing disorders to understand how symptoms change throughout the course of development and how this affects treatment. The information gained from this research will enable more specific treatments that are adapted to the needs of those with coexisting ADHD and ASD.
Medicines for anxiety
Autism is a multifaceted and difficult disorder that can create difficulties in a variety of areas, including emotions, concentration, sleep and behavior. While non-medicated treatment is often the first option, medication can often provide relief and give parents and children tools to aid them in achieving their goals. The medications used to treat ADHD can also help people with autism manage anxiety and depression.
Stimulant medication can be beneficial in treating the "core" ADHD symptoms that affect social, behavioral, and academic progress. For example, improving the ability to concentrate and complete tasks can make a a huge difference in writing, reading, and other academic abilities. Medical treatments can make a significant improvement in the capacity to communicate with your peers and also reduce the frequency of self-injurious behavior, tantrums and aggression may decrease too.
Antidepressants are sometimes prescribed to lower irritability levels in children with autism, and also to improve their mood. These medications include fluoxetine and are known as selective serotonin reuptake inhibitors (SSRIs). SSRIs are believed to be effective in treating anxiety, depression and other conditions among people with autism. However large clinical trials are needed to verify their effects.
Certain antipsychotics like Aripiprazole and Risperidone, are used to control the irritability, and emotional outbursts, that are common among people with autism. They aren't approved by the FDA to treat autism, but they can provide a useful tool to support improved emotion regulation in these children and adults.
Researchers are also working to explore how co-occurring autism and ADHD influence the trajectories of symptom progression over time. A better understanding of these relationships will hopefully result in more specific psychosocial and pharmacological treatments.
It is important to understand that medications can trigger adverse effects, and should be used with caution. It is recommended to test other options prior beginning treatment with medications particularly for children in the early years. If properly titrated the medications can help improve the quality of life for people with ADHD and autism.
Treatments for Emotions
If a child diagnosed with Autism is suffering from extreme anxiety or depressive symptoms they may become so severe that they cause problems with everyday functioning. In these situations doctors may prescribe medications to manage their emotions.
Treatments for ADHD can also be used to lessen anxiety and impulsivity, which are typical in autism. These medications are typically employed in combination with other behavioral treatments. Many medications, such as SSRIs are able to reduce anxiety and depression for people with autism. Other medications, like antipsychotics that are atypical and alpha-2 adrenergic antagonists, can reduce irritability among people with autism.
Researchers have recognized that autism and ADHD are often associated despite being distinct diagnoses. It is estimated that approximately half of children with autism show ADHD symptoms, including hyperactivity and inattention. As a result, many families are finding that they have to take medications to treat both disorders.
Children and adults with ADHD and autism are treated most commonly by medication. It is not meant to cure autism, nor to eradicate all associated behaviors. It can help manage certain symptoms that make it difficult for a child to function at school and in social settings.
Atypical antipsychotics such as risperidone can help reduce irritability in certain people with autism. These medications can also ease the psychotic symptoms, such as hallucinations or delusions that are common in those with autism.
It is important to note that the majority of the drugs that are approved by Health Canada have not been studied specifically in children or youth with autism. Most have followed a typical method to be put on the market, which includes clinical observation of a small group of people who have positive results, publishing of case studies, more off-label usage, open-label trials, and finally placebo-controlled controlled randomized study.
The most commonly prescribed medications for adolescents and adults with coexisting ASD and ADHD are methylphenidate (Ritalin, Concerta, Metadate), amphetamines (Adderall, Dexedrine, Vyvanse), and the atomoxetine (Strattera). These are also the medications most frequently prescribed for children suffering from pure ADHD. The medications used to treat anxiety, such as SSRIs, benzodiazepines, and anti-seizure medications, have not been extensively studied in this particular population, therefore the evidence of their effectiveness is less compelling.