Medication for AS?

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Last edited by OliveOilMom on 21 Jan 2012, 6:07 pm, edited 1 time in total.

http://autism.healingthresholds.com/therapy/drug

Above is a listing of some of the various drug treatments used to treat symptoms associated with autism.

As mentioned previously, my kids are both on Prozac by day and Clonidine at night (which works like Intuniv, which is included in the above list). My kids have both made tremendous improvement in speech, social skills, and behavior. Medication had greatly facilitated their progress by reducing anxiety and associated stimming, fixations, selective mutism (social anxiety disorder), meltdowns, and other distracting and negative behavior. My 7-year-old with high functioning classic autism would not be able to be in a regular second grade classroom (albeit with help coming into the classroom twice a day and tutoring at home) without meds.

Of course some of the higher functioning kids don't need meds, though. Of course some kids with AS make good grades. I've known a lot of very intelligent people with AS who did great in school and got good jobs.

I would probably qualify as having AS under DSM-IV but not meet autism criteria under the forthcoming DSM-5. I can do just fine without meds, particularly if I'm not under a lot of stress, and I earned 5 scholarships (4 purely academic and one partially based upon an essay about my experiences with epilespy), including 2 scholarships to law school, which I finished despite having uncontrolled epilepsy at the time. (It was later cured with surgery).

Very true. The key to doing stuff you aren't interested in with amphetamines is to make sure you completely clear your environment of anything remotely distracting, have everything needed to complete the uninteresting task on hand & ready to go, then take the amphetamines and isolate yourself from the rest of the world while forcing yourself to work on it. With a little luck, they'll kick in, and you'll be able to get it done.

The problem is that when/if something goes wrong, your uninteresting project is probably over for the day, because the moment you get derailed, nothing is likely to get you back in "the zone" and able to continue working on it the way you were. It's a very brittle way to get uninteresting/unmotivating tasks done, but often it's the only way they're going to get done at all, and it's the best strategy I've found so far for getting things done.

As an "experienced drug user", I recommend no drugs.

The only "drug" i will ever recommend to anyone, is of course marijuana, due to my own personal spiritual beliefs. And the fact that it's a more of a holy medicinal herb than a drug.

Thanks for the input. I really appreciate the time everyone is taking to answer.

We have only had his diagnosis for just over 2 weeks. This is truly all so overwhelming and it helps to see what works for some and works for others. My son's co-morbid conditions are SID & ODD. Right now, I only give him melatonin because otherwise, it takes him hours to fall asleep.

I'm not entirely opposed to medication. I just feel like it was offered as a suggestion before we have tried anything. I don't see how either of the doctors suggesting medication could accurately prescribe anything at this point. I don't feel like any medication should be taken lightly, but especially an anti-psychotic.

I've known since before he was 2 that he was different. I thought he had autism but our pediatrician assured me he was just really smart & quirky and was way to verbal to be diagnosed with autism.

He is in first grade and is doing amazingly well in school. He makes wonderful grades and gets the best color for behavior at school. Other than his quirkiness, I doubt AS is suspected at school. At home is where we deal with meltdowns, anger, etc. Every morning getting him ready for school is a battle. We have yet to find a routine that works well. The minute he gets in the car from school he melts down. These two areas are my main focuses right now. He is verbally abusive to all of us (except the baby) when he isn't in a good mood. He screams a lot. Socially, he is starting to have a more difficult time this year. He feels people hate him or are making fun of him. It really upsets him and generally it is because he is misreading them. Food textures and sounds are his main sensory issues right now. Things were definitely more difficult before he was school aged and we've come a long way, but if we could get through a morning without an argument or meltdown, I'd be a happy camper.

I had spoken about some of these difficulties at his 6 y/o well check with our pediatrician and he basically told me to work on parenting techniques. Basically, no dr ever took us seriously. We got new insurance that didn't require a referral to a psychologist so I made an appt because I was worried about his anger. After an hour with him, she wanted to test him for AS.

So, I guess that is why I am pretty shocked about medication being offered right off the bat. Just seems like they are saying "take a pill and make it better" without really even knowing what we need to work on.

This is probably a stupid question but did you take your child to a psychologist(who then referred you to a psychiatrist) or a psychiatrist?

The reason I ask, was that I would think a psychologist (who cannot prescribe meds) would be more likely to suggest non-med options.

We took him to a child psychologist. She referred us to our regular pediatrician for medication management. She referred us to OT, play based therapy & additional therapy with their office once he was established in OT, etc. She never referred us to a child psychiatrist, but I'm not certain there is one in our area. I could be wrong, but I'm not familiar of any.

As a small note, intuniv is the newest drug that is really being pushed right now. It is brand new and being pushed hard by Shire. While medication might be an option, I'd be leery of someone mentioning the newest drug on the market instead of offering several treatment choices.

For the record, Intuniv is a sustained-release version of Tenex (guanfacine, an alpha-2 agonist, which is NOT the same thing as "guaifenesin", the expectorant). If you can deal with giving it twice a day, generic Tenex is practically free compared to what you'll pay for Intuniv without insurance.

That said, I'd still recommend asking the doctor to try a low dose of dexedrine first. At any given dose, it either works, or it doesn't, so there's no need to put him through weeks of dysfunctional limbo waiting for it to start working or weaning him off of it. If you decide to stop, you can just stop... there's no need to taper off, or worry about side effects continuing.

If you see a little bit of an improvement with amphetamines, but it's not quite doing the job, you could also add Intuniv (or Tenex, if you don't have insurance). However, I personally think a minimal dose (possibly less than 25mg, prepared by a compounding pharmacy, possibly as a liquid with flavoring to mask the horrible taste) might be a better alternative to Tenex/Intuniv.

Alpha-2 agonists work by reducing the effect of released adrenaline. Adrenaline gets released when you're afraid. Beta blockers reduce the amount of adrenaline that gets released in the first place, and (IMHO) stops the problem at its source, instead of just trying to clean up the mess afterward.

For the record, I take 25mg/day of atenolol. Before I started, my resting heart rate was ~120bpm, and my blood pressure was (in retrospect) astronomical. Now that I take it, my heart rate and blood pressure are both completely normal. It doesn't take a lot of atenolol to do the job (hence, the likely need to compound it to a lower dose, like maybe 10mg/day, to get it down to something suitable for a child).

I once had a doctor prescribe valium (under some other name, I forget what it was) when I asked if he had any suggestions on how to help him get to sleep.

Um, no.

I think that here in the U. S. valium is mainly used with adults. It will definitely make a person sleepy.

[quote="happyhippiemama"]Thanks for the input. I really appreciate the time everyone is taking to answer.

I'm not entirely opposed to medication. I just feel like it was offered as a suggestion before we have tried anything. I don't see how either of the doctors suggesting medication could accurately prescribe anything at this point. I don't feel like any medication should be taken lightly, but especially an anti-psychotic.

quote]

I hear you. I don't think medication should be the first action taken. We avoided medication for many years, until it became clear in middle school that the stakes had gone up and my daughter really began to see significant difficulties in her ability to remained focused...the workload increased and she just couldn't keep up with peers, either in school or with homework at home. Pluse her behavioral issues became more of a problem as more was expected. She didn't begin taking meds until the middle of 6th grade. I think that if you can keep your child off of medication (esp when they are young and developing) you should. But if you see it becoming necessary, remember that it can be helpful. We tried natural remedies, diet...etc for years. All of those things were helpful to an extent. I agree that you shouldn't see meds as the only option just because someone says you should, esp if behavior or lack of focus isn't yet an issue.

B

Medications aren't going to help with any ASD symptoms other than (possibly) extreme irritability/agitation. When someone with an ASD is given medication, it should be for treating comorbid disorders, such as OCD, bipolar disorder, etc. For instance, I take OCD medication, but it doesn't affect my Asperger's obsessiveness (special interests and such) whatsoever. And I took a mood stabilizer for my intense (non-bipolar) moodiness, and it didn't really change anything. Thus, I believe that ASD obsessive-compulsiveness and moodiness may be different in the brain.

Yeah, I was shocked when I looked up the medication and found out what it was. No way I'd give a three-year-old something addictive like that.

The extreme irritability & agitation is probably our biggest hurdle right now.