Good Article Explaining How and Why Meds Are Used

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http://autism.about.com/od/treatmentopt ... tments.htm

Above in a simple article from 2009 explaining medication use.

To the article, I would add that Abilify, a newer atypical antipsychotic, is now often prescribed in place of Risperidone. (It may have fewer side effects; it is also a lot more expensive). Intuniv (a new drug which is like time-released Clonidine) may also be prescribed nowadays. (Intuniv is very expensive and, like Clonidine, causes sleepiness). You might ask to try a sample or try one of the older cheap drugs instead of one of the newer drugs before paying a lot for the newer drug, if you are not fully covered by insurance or have a high deductible.

Also, a child in the U.S. younger than the FDA approval age can be prescribed one of the meds discussed "off label." I strongly recommend having a pedicatric neurologist or child psychiatrist handle complicated medication issues and medications in young children.

Also, the stimulants should be used with great caution in kids with severe anxiety--comorbid OCD, selective mutism, and most kiddos with classic or low functioning autism. The stimulants can increase focus and attention; however, they also increase anxiety.

In my case it was laziness of the phycatrist. Instead of trying to get the bullying situation under control, she just wanted to pump me full of prozac.

I worry about these drugs. There are several new books out on why no one should take them, or at least only a small fraction of those who currently do. It really should be last resort effort, not protocol.

I don't like drugs myself; in fact the only drug I have taken over the last thirty or more years is coffee. I'm also aware of the fact that the rest of the world takes less drugs than the US and there are concerns about the influence of the big pharma companies there, and the problem of doctors prescribing medication as an "easy fix". Many drugs have unwanted side effects, some serious.

That stated I am very open to considering the use of drugs. Our son was originally diagnosed ADD-inattention. I went to an ADD seminar a few years ago and was very impressed by a Sydney psychiatrist who said that technology was now advancing so that they were starting to show differences in brain scans between ADD persons and NTs, which they could not see before. (I know this is ADD not ASD, but suspect a similar effect). The Sydney psychiatrist said that this was the reason he recommended Ritalin; the brain was not functioning properly and the medication ameliorated that. Just like you take insulin for diabetes.

Personally my schizophrenic wife would not cope (ie would, and has had, psychotic breakdowns when off medication or on the wrong medication). And I think Ritalin has been somewhat helpful for our son.

My wife is particularly keen to explore medication for our son, as she knows the difference this makes for her (even with the very unpleasant side effects). We know another boy on the ASD spectrum who has benefited from a low dose of risperidone.

I believe that it is really important in the younger years to help the child cope with behavioral training and therapy. It gives them a good foundation. When they get a bit older and have more of a voice in their treatment, then I think it is a better time to discuss that option. Just my personal take.

I was never into meds for kids, but I saw the huge differense medication made to our son.
The dr was very carefull, always started with the lowest dosage and didn t force anything on us. We had very bad side effects on Risperdal....my son became like a trapped wild aggressive animal in a cage! then he was on Tofranil...increasing his anxiety and vomiting.
But now he is on Cyprelex, an Antidepressant.....his anxiety, moods and obsessive thoughts is SO MUCH better....can t see any side effects, just bit of weight gain.
The pdoc explained that the meds had to first start working, making him a bit more "flexable"....before we could start the speech and occupational therapy, his anxiety needs to be decreased at first. She also gave us parent counselling to teach us better coping skills.....

Uiters goed (very good), lovelyboy.

Have had another look at the article about medication, especially as my schizophrenic wife is so very keen to try other medication for him.

Of course it may be that his autism is really prodromal schizophrenia (I hope to hell not) in which case there might be something to the medication; but it seems to me that the medication is aimed at behavioral issues/co-morbid conditions/neurotic issues (eg anxiety), with only the stimulants like Ritalin (which he is already on) for better brain functioning. The problem is, our son is not depressed, he is not anxious, he does not really have behavioral issues such as anger etc. He does get very antsy and walks or runs up and down the house, but that is his ADD in my view, and can be dealt with by exercise and his Ritalin.

Our friend who has used risperidone for her ASD son with success has said he has anxiety and some minor violence issues; none of that applies to our son. I wish he were more anxious eg about his schoolwork!

By the way my wife used abilify for her schizophrenia. She went well on it at first, but it was an absolute unmitigated disaster, as it did not control her psychotic delusions; we may still be bearing the scars of all that - her trial of abilify was in 2008. That has nothing to do with whether it may not work well for other conditions of course.

The psychiatrist who diagnosed our son as ASD said he is just different and we need to adjust our minds to that; I think we are likely to find this is the case rather than to find medication that can work as relatively well as the antipsychotic drugs have worked for my wife's schizophrenia.

http://youtu.be/YFQZekpKxW4

My theory on medication is a lot in line with what this doctor/professor of child and adolescent psychiatry says in this YouTube video from the "favorites" section of my Autistic Kids Channel. He discusses a recent research study of autistic kids which found that the majority (not all) had comorbid psychiatric conditions, creating an opportunity for medication use in order to alleviate some of their symptoms. The kids did not all have a comorbid psychiatric condition, and they did not all have the same condition.

The study did not focus on kids with AS and included many kids with classic autism symptoms.

I have always been against meds. I have tried dietary changes. We also had 2 trials of SSRIs that had side effects. However, we are waiting for an appt with a child psych to discuss meds. My daughter, while in some ways has been doing better- in a lot of ways she has been so much worse. This includes constantly refusing to go to school, having issues with the kids at school, being too frustrated to do homework, being aggressive with me and other children, being self abusive in meltdown mode, refusing self care like bathing, brushing teeth, brushing hair, etc. I just can't see her living this way for any longer. If I can help her feel less anxious, less hostile, and calmer with meds I WILL DO IT. I feel that if I don't medicate her she will end up in in-patient care in the future. And I might end up there too if I don't change something.

The more I read about the subject, the more I support meds. Especially when the benefits outweigh the risks, I think the child should be tried on a low/safe dose of medication for whatever issue(s) they're having. Most of the meds used for ADHD, Autism, Depression, Anxiety, etc. are VERY safe at low doses and when used under a doctor's care. Ultimately, I don't think it's fair to let a child suffer because of a parent's preconceived (and often false) notions about medication.

I think if a child is suffering it is one thing; but if a child is merely struggling, that is another. When things were most difficult for my son I asked him if he wanted to try medication and he had one question: will it change how I think? And the answer is that it might. He wanted no part of it; he was PROUD of thinking differently, jumpy brain, and the whole nine yards, and while he was struggling with sensory issues and meltdowns and so forth, he has always considered it more the fault of the environment than of him.

And he was always right on that: it was more the environment than him.

If a child can thrive in summer vacation then school is the problem, not the child, and why are we medicating kids to do better at school when the school is at fault, not them?

We do NOT know the long term effects of these drugs. It is a dangerous game to play, altering brain chemistry, and while there are times is necessary, and times it literally changes someone's life, I don't think it should be done when the fault isn't inside the child's brain to start with, but with the environments our modern world is trying to force kids into.

I'd rather change the world, myself

I have taken anti-depressants and they are really, really, REALLY hard to go off of. Your brain becomes dependent on it. There is no "lets do this a little while and get past the hurdle." I've been through it, I know.

I just think too many people rush too fast into it. It is simply becoming the protocol, and that is scary. My son ended up doing GREAT and working through all his issues WITHOUT a single drug. I know he has been super lucky, no depression or anxiety co-morbids, really high functioning, and so on. But he isn't that out of the norm, either. We just never gave up, always tried one more thing, and every time I was "that" close to saying, "OK, we'd better try medication," one of those other things clicked, and we knew we had absolutely done the right thing by waiting.

Mama to Grace, I know you've tried everything, and choices can be limited. I make the sales pitch because I want to people to truly consider what their options may be.

Way back when my son was an infant, I talked to a family about a nanny share (I was looking at that as a way to share costs and maybe even make it more fun for my child). They were referred to me after it became evident their child had low illness resistance, and was getting far too sick in group childcare, way beyond the norm. After she talked about how upset she was with the illness situation, and worried for her child, we talked costs and how a share would work, and at the end of this conversation the mom told me that she thought she would have to give up on this idea and just send her child back to the childcare, because "how could they save any money if they were paying so much?" OK, that I could NOT understand. If people can't pay their bills that is one thing, but why would she put her child in a situation that she had finished telling me was not working so she could get ahead financially? I cleared out 10 years of savings getting my infant son what he needed before he turned five; not falsified needs, not luxuries, things it was clear he NEEDED. In my mind, that is what parents are supposed to do.

I worry about what happens when someone like that mom find out their child is AS. I can't imagine her trying the rough road; I think she would always jump onto the easy one. Problems at school? Just medicate, solved.

Except it isn't. It just isn't that easy.

I think parents need to know that.

Everyone who has posted here for a while does know that, but we get new people all the time.

Other methods can be effective but, no, not always. And not everyone has the same options. The whole menu always has to be out there. In my opinion, anyway.

Yeah, I know there are a lot of people who medicate upon diagnosis. On my daughter's diagnostic report under recommendations medicating her was suggested.

I am researching every option. I know there's just no way I can go along with an anti psychotic at age 8, but I know there are some kids who are far more violent and I do not begrudge those parents. It is a living hell when you cannot stop your child from beating down the wall or their door or their window.

SSRIs have not helped my daughter so I have to look outside of that box. I am looking at Clonidine or Tenex or Intuniv (I think they are all similar in action). These are all alpha agonists:

from Wikipedia:
"Another psychiatric use of guanfacine is for treatment of anxiety, such as generalized anxiety disorder and post-traumatic stress disorder symptoms. Alpha-2A agonists such as guanfacine reduce sympathetic arousal, weaken the emotional responses of the amygdala, and strengthen prefrontal cortical regulation of emotion, action and thought. All of these actions likely contribute to the relief of the hyperarousal, re-experiencing, and impulsivity associated with PTSD.[9] Due to its prolonged half-life, it also has been seen to improve sleep interrupted by nightmares in PTSD patients.[10] According to recent studies (Srour et al., 2008) there is controversy as to guanfacine’s usefulness in treating tics. There has been success when tic symptoms are co-morbid with ADHD, and as such, guanfacine and other alpha-2-adrenergic agonists (clonidine) are commonly the first choice for treatment....
In animal models, guanfacine is seen to affect a number of cognitive factors, including working memory improvement, distractibility reduction, response inhibition improvement, and attention control.[14] Performance increases in spatial working memory have also been observed in humans."