Now to the controversial area of medication. While it is certainly worth trying a sensory and dietary approach first it would be foolish to ignore the fact that the correct medication – given in the right amount – can help at times.
A sweeping statement? No. Firstly it is based on my own experience of seasonal affective disorder (SAD) – a depressive illness that tends to happen as the days get darker. While in the past it has sometimes responded well to herbal remedies there have been some years when a stressful situation had compounded the SAD and I have found that the only way to alleviate the symptoms has been medication.
More importantly, some people on the autism spectrum like Temple Grandin and David Miedzianik have also found the correct medications to be beneficial in reducing their anxiety levels and associated difficulties.
Types of medications often used in treating people with ASD
If you’ve been following this series you will know that I believe that alleviating stress can help to reduce the symptoms of anxiety – and will, in turn, generally lessen ‘aggressive’ behaviors, obsessive or compulsive behaviors – and more. Even so the choice of drug is individual and could include medications used to help obsessive or compulsive behaviors, hyperactivity, behavioral problems, depression or anxiety.
Some of the most common are:
• Drugs for anxiety disorders (eg beta blockers like propranolol)
• Selective serotonin re-uptake inhibitors (SSRIs) like fluoxetine (otherwise known as Prozac). These are used in the treatment of anxiety disorders and depression, in children and adults.
• Naltrexone – has been found to ease disabling repetitive and self-injurious behaviors in some children and adults with autism.
• Atypical antipsychotics (like risperidone), are often used to treat a variety of symptoms like irritability, aggression, self injury hyperactivity and stereotyped behavior. These are frequently associated with sedation, especially early in the course of treatment.
Unfortunately people often misunderstand how drugs work. Several years ago one report described a careworker who, recklessly (and stupidly), tried some of the medication prescribed for one of his clients. Unsurprisingly it had a detrimental effect on him and so he reduced his client’s medication without reference to the doctor: although how the sudden reduction affected his client was not recorded.
How they work:
• Each medication is designed to help with a specific problem so it won’t produce similar results in a healthy person.
• The efficiency of our bodies to cope with medication also means that the dosage is individual.
• If you become accustomed to a particular drug your body may begin to eliminate it more efficiently, which is why the dosage may need to be increased at times.
Trying to make this decision for your child? It is especially difficult to remain objective, but as ever, quality of life is a crucial deciding factor. The child or adult who is constantly agitated is not going to be happy (anymore than you would) and so, if the problem hasn’t been alleviated by other means, medication may well have a vital part to play.
- If medication is suggested for your child don’t simply dismiss the idea.
- Talk to your doctor both about the potential benefits and possible side effects and question the alternatives.
- Consider all the facts and discuss it with all concerned before you make a decision.
Remind your doctor that:
- Some people with autism don’t react to medication as others might – so that tranquillizers for instance can often have the opposite effect to the one you expect. (Possible reasons include an underactive nervous system, metabolic differences, allergies, digestive problems).
- Some people with ASD react better to lower doses that to larger ones.
If you do opt for medication remember:
• The child with limited communication skills won’t be able to tell you how he feels, so you need to monitor his reactions carefully.
• Use a daily diary to record all side effects (both good and bad) – as it is all too easy to forget exactly what happened when.
• Contact your doctor if you have any concerns/questions.
• Reductions/alterations in medication should take place under a doctor’s supervision and need careful observation.
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