Welcome to another day in the A to Z Challenge, in which I focus on autism. Today, I will discuss psychiatric medication as a treatment for autistic symptoms.
Many autistic children and adults take one or more psychiatric medications. Most of these are prescribed off-label, which means they have not been approved by the U.S. Food and Drug Administraiton (FDA) or similar agencies in other countries for the specific purpose of trating autistic symptoms, but the doctor feels they may benefit an autistic person anyway. In 2006, risperidone (Risperdal) got approved for the treatment of irritability in autistic children ages five to sixteen. In 2009, aripiprazole (Abilify) got approved for this purpose too. Both of these medications were originally developed for treating psychotic symptoms in people with schizophrenia, but they are commonly used for treating irritability in people with conditions like bipolar disorder too.
Antidepressants are also commonly prescribed to autistic children and adults because of their potental effectiveness in treating anxiety, depression and obsessive-compulsive symptoms, all of which are common in autistic people. Fluoxetine (Prozac) has been FDA-approved for treating both obsessive-compulsive disorder and depression in childern age seven and up. Citalopram (Celexa) was specifically studied for its effectiveness in treating repetitive behaviors in autistic children, but was not found to be very effective.
Since many autistic people have comorbid attntion deficit (hyperactivity) disorder, many also take stimulants like methylphenidate (Ritalin or Concerta). Some autistic people take anticonvulsants, usually for epilepsy, but these medications can also be used as mood stabilizers.
Many autistic people have strong opinions on medication. For example, many people feel that medications are too often used in a situation where there is limited support in order to drug someone into compliance. A few years ago, I read of a study on intellectually disabled people in institutions, which compared the classic antipsychotic Haldol to Ripserdal and placebo. Each, including placebo, was equally effective, presumably because the people in the study got quite a bit of attention from researchers and this decreased their aggression. I have mixed feelings about this. I may’ve written earlier that I was prescribed Risperdal a week before moving into independent living in 2007. In this situation, clearly the medication was used as a substitute for proper care. However, since going on Abilify (and Celexa) in 2010, I have also been feeling significantly better and more able to cope. When you get your child on medication, it is important to change the medication only and allow other circumstances to remain as much the same as possible. Otherwise, you won’t be able to test whether the medication works.