Aspergers and Medication

"Are there any medications on the market to treat a child Asperger's Syndrome? If so, which ones have had the greatest benefit to those with the disorder?"

Because there is no identifiable biochemical problem in Aspergers Syndrome or High-Functioning Autism, and because many researchers believe the syndrome is a result of fundamental changes in the brain structure, medications will probably never treat or cure it. On the other hand, there are several medications that have been found to control some of the symptoms of Aspergers Syndrome or the comorbidities found with the condition.

A medication called atomoxetine has been found to improve some of the aspects of Aspergers Syndrome that mimic those of attention deficit disorder. Several studies have used the drug to reduce symptoms of irritability, social withdrawal and repetitive speech seen in this disorder.

Medications normally directed toward treating obsessive compulsive disorder have been tried in children with Aspergers Syndrome who have shown obsessive and compulsive tendencies. While the medication doesn’t treat some of the core symptoms of Aspergers Syndrome, it has been shown to improve OCD symptoms.

Antidepressants can be attempted in those Aspergers individuals who suffer from secondary depression. The depression isn’t generally a part of the Aspergers Syndrome itself, but is found as a result of some of the distressing life circumstances often found in Aspergers Syndrome. Many of these children and teens know that they do not fit in with others, and while some prefer social isolation, others lament their lack of ability to get comfortable dealing with others. This and other issues of self-esteem, etc., can lead to depression, which is often manageable with antidepressant medication.

Finally, people with Aspergers Syndrome often suffer from debilitating insomnia. While it’s best to use non-drug ways of controlling the symptoms, some people can make use of sleeping medication that doesn’t have to be addicting. Sometimes a short course of sleeping medication can get the individual back into a regular sleeping pattern.

Medications directed at anxiety may be necessary when the person with Aspergers suffers from nervousness or irritability surrounding their life situations. "Aspies" can become quite distressed by things not being the same or as expected, and anti-anxiety medication can help with this.

In truth, there is no single medication or class of medications that works to treat many of the core symptoms of Aspergers Syndrome. Some of the secondary or related symptoms can be effectively managed, however, with certain psychotropic medications.

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Best comment:

Medication will help in very specific ways. Medication helps in reducing panic attacks, anxiety and aggression and explosive behavior. AS kids have restricted interests by definition of the disorder. They focus in on details on whatever it is they are talking about. Even with medication. But it helps to have the medication reduce some the stress. A good book to refer to for doses for AS kids is "Clinical Treatment of Autism" by Dr. Eric Hollander (From Mt. Sinai Autism Center) For example, AS kids start at low doses of Zoloft (25mg up to 50mg) or Prozac (10mg up to 20mg).

What else is needed is a different approach. Many activities need to be rehearsed in very small steps over years of exposures. And with a positive reinforcement plan. I have found Yale University Parent and Child Conduct Clinic very helpful. I have been trained by them on the phone over the last two years.

Here are some strategies:

1) Avoid stores with him until you can work on a behavior plan with him on this. When you have time, he needs to be taught to shop from a list, stick to a budget, ignore items he sees that are not on the list and that shopping is a reward to be earned by doing both. Tagging along with parents shopping is going to be irritating to him for a long time in the future.

2) Only pair him up with kids that are younger or not challenging personalities. Make the social activity predictable (movie, with defined snacks), or (park and a drink and chips we bring with) or (bowling 2 games and a snack and drink). Rehearse the social activity. And praise all positive behavior. Often as they get older, they will start to be able to be more flexible with peers.

3) Practice talking at meals about pleasant things that others are interested in. Don't allow dinners to be all special interests all the time. Practice at some meals taking an interest in the parent’s interests or other members of the family. This is a skill that takes time to develop. If he was shut out of conversation all day at school, then dinner may be his time to talk about his interests. It may have to wait until a less stressful time of the year to practice this skill.

3) Church is going to be difficult. All those people and the noise from all directions. It is an irritating place for many AS kids. My daughter goes to Sunday school (and I have taught the class for 8 years) not church services (except for Christmas and Easter when there is lots of music and we attend the children's mass).

I think parent's need support from a behaviorist. Parents of typical kids and teachers will not understand that these kids need very small steps and exposures to life in general.

Teachers and school staff will push too hard, it is only a certified behaviorist of autistic kids that understand behavior shaping is a slow process of gradual change with positive supports.

A better day for your son would be:

1) Lunch at his favorite place with you only. Agree on your limits ahead of time. The less limits the less irritated he will be. So pick an affordable place with food choices that you approve of.

Practice menu choices. Without a fight. Practice budget. When he can go to the lunch place without a meltdown over menu choices he is ready for your boyfriend to be there and then his son.

The goal of this exercise is to have a positive social experience. Don't expect to go to a busy noisy rushed place at lunch on Saturday with a group of people and expect him to be well behaved. It all has to be rehearsed and practiced.

2) Find him a church setting where there is very small Sunday school groups for kids his age. Let the teacher know he needs support and understanding.

3) Melatonin tablets are very helpful for relaxing AS kids at bedtime. This really works. The Mayo Clinic recommends them an hour before bedtime. I forgot the dose I use for my daughter, look at the Mayo Clinic web site on Asperger kids and medications. It has made a huge difference for my daughter. She use to get very anxious and had a busy mind at bedtime. Now she is asleep within an hour.

4) Follow this plan: One outing a day, one place, and allow 1 hour or more. Don't rush him to leave. Give him a warning. Offer a small reward if he leaves calmly when it is time.

There is so much to share about parenting an AS child. This is a rushed summary, and I am rushing through the details. But it is meant to give you an idea of the strategies that work. You will find a behaviorist very helpful. Yale was affordable for me. $75 for 45 min and I did get some money from insurance back. 


 More comments:

•    Anonymous said...  1. It's not a 'disorder' 2. No there is no suitable medication 3. Start finding ways to ease the anxieties, not turn children into Zombies with drugs. Rant over
•    Anonymous said...  Allison, My almost 12yr old grandson has been on Risperdol since he was 3. He has had no side effects other than weight gain which is under control with diet. His parents did take him off one summer & everyone, including our Aspie, was miserable due to daily meltdowns. Monitor closely but don't let peers pressure you to DC meds for no good reason.
•    Anonymous said...  Catapres nightly to assist sleep (age 7)
•    Anonymous said...  Dietary changes, ABA & OT therapy, and counseling have all been beneficial for our son/family. Our son no longer does OT, counseling is on an as needed basis and he'll most likely be done with ABA therapy too. As for the diet, that is a lifestyle change. We've also found great support through our church family & getting him involved with youth group & more structured type activities that he enjoys.
•    Anonymous said...  Everyone is entitled to their opinion, so this is mine. Why do people get so tetchy over words? Who cares what it is called as long as no offensive words are used. Why are people so against medication? Surely it is up to the individual parent. I know for sure I would much rather my daughter be stable than having her slit her wrists all the time because her mother didn't think she was worth enough to help her with medication. Many other therapies have been tried but failed because of her lack of communication ability be it verbal or otherwise. I would not deny my daughter calpol if she had a headache and would not wish for her to suffer the pain instead so who am I to deny her a chance of an anxiety free life just because of my belief against medication! Rant over!!
•    Anonymous said...  Go to the Amen clinic. They are wonderful!
•    Anonymous said...  I always caution, when considering medication for children, people to make sure they clearly weigh the pros and cons. Some medications for social issues (depression/anxiety) end up seeming to work and then backfire with symptoms that are even more aggravating including suicidal tendencies or violent outbursts. For so many medication works for many things, but since, as the article says, autism has not been found to be any particular imbalance that can be corrected, it may well be the best option is for us to make our environments more aspie/autism friendly than to try to force change at a medicinal level in them.
•    Anonymous said...  I would suggest starting with therapy, and see what direction that sends you in. There are so many medications you can put them on but lots of them have many cons.
•    Anonymous said...  I would suggest therapy also. Our son is not on any meds, but has been seeing a therapist for 2 years, and it has made a world of difference in his behavior. Medication may help some, but for us, we want that to be the very last option we choose.
•    Anonymous said...  My boy uses meds to help with his focus at school. I have had to educate our school a lot about reinforcing bad behavior. Education is the key. I would probably use meds even if we homeschooled. He tells me it is liked having steering and breaks. He feels more in control.
•    Anonymous said...  My daughter was on Risperdol and went off the deep end. She hasn't been on any meds (except melatonin) since age 7. Now shes in full blown puberty and NEEDS anti anxiety meds. No amount of therapy has helped, and she could hurt herself or someone else if she can't calm down.
•    Anonymous said...  My son began taking medication for anxiety when he was a teen. It has helped a ton. He still gets anxious, but it is not completely debilitating anymore. The medication side effects are very minimal as he takes a low dose.
•    Anonymous said...  My son is an aspie that also has adhd. He's six and takes vyvanse and tenex. I hated putting him on meds but sometimes you just have to.
•    Anonymous said...  Risperdol has been a life saver for my 14 year old son with Asperger's. His aggression has reached scary proportions and this med has helped with his anger and meltdowns. He also takes Lexapro for his high anxiety. I agree that it's the parent's choice...we all want the best for our children medicine or not. I honestly do not think my son could live with our family if he wasn't on medication.
•    Anonymous said...  risperdol has been a life saver for us as well, though with my son only being 5 years old I'm not sure how long I'll be willing to keep him on it, at least not for long term, we're thinking to just use it for the months he's in school. He also takes Fluvox for his OCD which has really helped him as well.
•    Anonymous said...  There is no medication for Asperger's. There are, however, medications for comorbid diagnoses such as OCD or ADHD. For Asperger's in and of itself, there is none.

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