What Medicines are Used to Treat Autism?

Medications are often used to treat the behavioral problems, such as aggression, self-harming behavior, and severe tantrums, that keep someone with autism from functioning more effectively at home or school. The medications used are those that have been developed to treat similar symptoms in other disorders. Many of these medications are prescribed “off-label.” This means they have not been officially approved by the Food and Drug Administration (FDA) for use in children. However, the doctor prescribes the medications anyway if he or she feels they are appropriate for the child. Further research needs to be done to make sure these medicines are both effective and safe when used in the treatment of children and adolescents.

A child with autism may not respond to medications in the same way as children without autism. Therefore a child should be monitored closely while taking a medication. It is important that parents work with a doctor who has experience with children with autism. The doctor will prescribe the lowest dose possible to be effective.

Parents should ask doctors about any side effects the medication may have and keep a record of how the child responds to the medication. It will be helpful for parents to read the “patient insert” that comes with the medication. Some people keep the patient inserts in a small notebook to be used as a reference. This is most useful when several medications are prescribed.

SSRIs

The selective serotonin reuptake inhibitors (SSRIs) are medications most often prescribed for symptoms of anxiety, depression, and/or obsessive-compulsive disorder (OCD). Only one of the SSRIs, fluoxetine, (Prozac®) has been approved by the FDA for both OCD and depression in children age seven and older. Three that have been approved for OCD are fluvoxamine (Luvox®), age eight and older; sertraline (Zoloft®), age six and older; and clomipramine (Anafranil®), age 10 and older.4 Treatment with these medications have been shown to decrease the repetitive, ritualistic behavior and help improve eye contact and social contacts. The FDA is studying data to better understand how to use the SSRIs safely, effectively, and at the lowest dose possible.

Antipsychotic Medications

Antipsychotic medications have been used to treat severe behavioral problems. These medications work by reducing the activity in the brain of the neurotransmitter dopamine. Among the older, typical antipsychotics, such as haloperidol (Haldol®), thioridazine, fluphenazine, and chlorpromazine, haloperidol was found in more than one study to be more effective than a placebo (fake drug) in treating serious behavioral problems.26 However, haloperidol, while helpful for reducing symptoms of aggression, can also have negative side effects, such as drowsiness, muscle stiffness, and abnormal movements.

Studies of the newer antipsychotics are being conducted on children with autism. The first study was on risperidone (Risperdal®).27 Results of the eight-week study were reported in 2002 and showed that risperidone was effective and well tolerated for the treatment of severe behavioral problems in children with autism. Further long-term studies are needed to determine any long-term side effects. Other antipsychotics that have been studied recently with encouraging results are olanzapine (Zyprexa®) and ziprasidone (Geodon®).

Seizure Medications

Seizures are found in one in four persons with autism, especially in those who have a low IQ or who cannot speak. They are treated with one or more of the anticonvulsants. These include such medications as carbamazepine (Tegretol®), lamotrigine (Lamictal®), topiramate (Topamax®), and valproic acid (Depakote®). The level of the medication in the blood should be monitored carefully and adjusted so that the least amount possible is used to be effective. Although medication usually reduces the number of seizures, it cannot always eliminate them.

Medications for Inattention and Hyperactivity

Stimulant medications such as methylphenidate (Ritalin®), used for people with attention deficit hyperactivity disorder, have also been prescribed for children with autism. These medications may decrease impulsivity and hyperactivity especially in higher functioning children.
Several other medications have been used to treat ASD symptoms; among them are other antidepressants, naltrexone, lithium, and some of the benzodiazepines such as diazepam (Valium®) and lorazepam (Ativan®). The safety and effectiveness of these medications in children with autism has not been proven.

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National Institute for Neurological Disorders
www.ninds.nih.gov