Medicines have a limited role in improving symptoms of
autism. However, some may help prevent self-injury and
other behaviours that are causing difficulty. Medicines may also take a child
to a functional level at which they can benefit from other treatments.
There is no standard medicine for the
treatment of autism. The American Academy of Pediatrics (AAP) suggests
targeting the main one or two problem behaviours when considering
medicines.1
Medicines that are sometimes used to treat behaviours related to
autism include selective serotonin reuptake inhibitors and antipsychotic
medicines.1
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) include citalopram
(Celexa), fluoxetine (Prozac), and sertraline (Zoloft). The high rate
of effectiveness for depression, anxiety, and obsessive, stereotypical
behaviours has made these medicines a popular choice for managing autism. They
may also improve general behaviour, language, learning, and socialization. In
addition, although SSRIs have side effects, such as weight gain, insomnia, and
increased agitation, they tend to be less serious than those of antipsychotic
medicines.
Advisory. Health Canada and the U.S. Food and Drug
Administration (FDA) have issued advisories to patients, families, and health
professionals to closely monitor adults and children taking antidepressants for
warning signs of suicide. This is especially important at the beginning of
treatment or when doses are changed.
Health Canada and the FDA also advise that patients be observed for increases in
anxiety, panic attacks, agitation, irritability, insomnia, impulsivity,
hostility, and mania. It is most important to watch for these behaviours in
children who may be less able to control their impulsivity as much as adults
and therefore may be at greater risk for suicide. Health Canada and the FDA have not recommended
that people stop using antidepressants but simply to monitor those taking the
medicines and, if concerns arise, to contact a health professional.
Antipsychotic medicines
Antipsychotic medicines, such as haloperidol (Haldol),
risperidone (Risperdal), and thioridazine work by changing the effects of brain
chemicals. They may help decrease problem behaviours that can occur with autism.
A well-designed study found that risperidone was effective
for the treatment of tantrums, aggression, and self-harming behaviour in
children with autism.2
However, these medicines can have side
effects, including sleepiness, tremors, and weight gain. Their use is usually
considered only after behaviour management has failed to address the problem
behaviours.
Other medicines that are sometimes used
include:1
- Clonidine (Catapres). This medicine is typically used to lower blood pressure but is also used to treat impulsive and aggressive behaviours in children with autism.
- Lithium (Duralith, Lithane)
and anticonvulsants, such as carbamazepine
(Mazepine, Tegretol)
and valproic acid
(Depakene). Children who are
occasionally aggressive may become more stable when using these medicines,
although monitoring the level of the drug in the body through regularly
scheduled blood tests is required.
The effectiveness of these medicines varies by individual. Side
effects are possible and should be discussed with your
health professional. Some health professionals may advise going off a
medicine temporarily, in order to identify whether it is having a positive or
negative effect.