List of Questions to Ask Before Considering Medication

by Autism Spectrum Directory

Question 1. Is there a formal diagnosis of an Autism Spectrum Disorder?

Yes -> Go to next question

No -> Ask your doctor to refer for a full assessment

Question 2. Have you removed any potential environmental factors that could be impacting symptoms of the autism spectrum disorder, such as food allergies or intolerances, chemical sensitivities or other environmental toxins?

Yes -> Go to the next question

No -> Remove environmental causes and evaluate if symptoms improve

Question 3. Medication should be viewed as a footnote to treatment and is only one part of a comprehensive treatment approach, have you tried other treatments before medication?

Yes -> Go to the next question

No -> Consider using other treatments, therapies or interventions to improve symptoms of an autism spectrum disorder

Question 4. Are you looking to medicate core symptoms of autism spectrum disorder? Core symptoms include impairment in social interaction, impairment in communication and/or language, and restricted and repetitive behaviors or interests.

Yes -> There are no medications currently available for Core symptoms. Treatment options are non-medication based therapies and interventions

No -> Go to the next question

Question 5. Are you looking to medicate ‘target’ co-occurring symptoms of seizures, aggression, and self-injury, irritability, property destruction, hyperactivity, inattention, or repetitive behaviours?

Yes -> Target symptoms may be modified with medication. Talk to your doctor about which medication would be best to modify the symptoms

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Types of medication for Target Co-occurring symptoms

Symptom: Irritability, aggression, self-injury, property destruction

  • Traditional antipsychotics
    • Dopamine antagonists – block dopamine receptors in the brain
    • Effective in small randomized controlled trials
    • Risks of tardive dyskinesia, an irreversible side effect in a small number of cases
    • Atypical antipsychotics
      • Mixed mechanism of action
      • Promising in case series and open trials
      • Lower risk of dystonias
    • Risperidone
      • studies show high rate of effectiveness for aberrant behaviour in Autism
      • better results achieved if used with psychosocial interventions such as parent training, visual schedules, positive reinforcement, functional communication skills, behavior rehearsal and feedbackfor problematic behaviours
      • side effects are weight gain and potential future metabolic problems
    • Aripiprazole

Symptom: Hyperactivity, inattention

  • Stimulant medications
    • Commonly used for symptoms of ADHD, not as useful for symptoms in Autism
    • Adverse side effects of stimulant medications
      • Worsening of repetitive behaviors
      • Irritability
      • Social withdrawal
    • Types of methylphenidate and amphetamines (stimulants)
      • Ritalin
      • Dopamine antagonists – increase the levels of dopamine in the brain, this is a contradicting effect to what antipsychotic medication does

Symptom: Repetitive behaviours

  • Repetitive behaviours similar to OCD
  • Strong support for SSRI medication in OCD
  • Evidence of serotonin metabolism is abnormal in autism
    • Elevated serotonin in blood a consistent finding
    • SSRIs block the uptake of serotonin
    • Preliminary finding in adults with autism that SSRIs are helpful
      • Useful medication for depression and anxiety common for higher functioning people on the autism spectrum who have a heightened awareness of their social disability
    • Types of SSRIs
      • Prozac
      • Fluvoxamine(Luvox) – study showed substantial improvements in repetitive behaviours
      • Citalopram (Celexa, Cipramil)
        • No better results than placebo
        • Poorly tolerated with side effects of impulsivity, hyperactivity, insomnia, behavioral action

Source: https://autismspectrumdirectory.wordpress.com/2010/12/29/psychopharmacology-medications-for-an-autism-spectrum-disorder/

Copyright Autism Spectrum Directory

Other Resources

Book: Taking the Mystery Out of Medications in Autism/Asperger’s Syndromes

Book: Autism, Brain And Environment

Book: How to Talk to Parents About Autism

Book: Mental Health Aspects Of Autism And Asperger Syndrome

Book: Is My Child OK?: When Behavior is a Problem, When It’s Not, and When to Seek Help

Book: The OASIS Guide to Asperger Syndrome: Advice, Support, Insight, and Inspiration

Book: Diagnosis Autism: Now What?

MP3: Bottles Of Pills – Medication Options For Autistic Patients

Related Articles:

Medications (Psychopharmacology) for an Autism Spectrum Disorder

Complete List of All Articles on Autism Spectrum Directory

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Comments
2 Responses to “List of Questions to Ask Before Considering Medication”
  1. This is an excellent resource for families trying to figure out which way to turn.
    It truly is “all about the symptoms” you are trying to treat. Thank you!

  2. autisme says:

    Thank you for bringing this issue to light. Here’s another site which brings up some very serious side effects of antipsychotics used in treating behaviors in autism. Google: “Autistic behaviors, Antipsychotics and Angioedema: Warning”

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