Types of Autism Medications and Treatments

Autism medications are prescribed to treat some of the behavioral symptoms associated with autism spectrum disorder (ASD). At present, there is no medication to cure autism spectrum disorder or relieve all of its symptoms. Behavioral therapies form a crucial pillar of treatment.

Autism medications are prescribed to treat some of the behavioral symptoms associated with autism spectrum disorder (ASD). At present, there is no medication to cure autism spectrum disorder or relieve all of its symptoms.

Autism medications may be useful for managing certain behaviors associated with ASD such as:

• Self-injury
• Aggression
• Hyperactivity
• Inability to focus
• Anxiety and depression

The only medications approved by FDA for irritability associated with autism spectrum disorder are the two following second-generation antipsychotic class of drugs:

• Aripiprazole
• Risperidone

Other medications such as selective serotonin reuptake inhibitors (SSRI), stimulants and alpha-2 adrenergic agonists are prescribed off-label for managing some specific symptoms associated with ASD.

Autism is a complex developmental disorder that affects behavior and impairs social and communication skills. Autism is a spectrum of conditions with symptoms ranging from mild to severe. High-functioning individuals with ASD can be gifted with exceptional skills, while people with severe forms of ASD may never be able to live independently.

Autistic disorder becomes evident in early childhood, though many children with ASD may appear normal in infancy. Boys are found to be four times more likely to have ASD. Some of the characteristics of children with autism spectrum disorder include:

• Regression in development that initially seems normal
• Not pointing at objects to show interest
• Lack of reaction or excessive reaction such as screaming or rage, to sensory stimuli such as touch, bright lights, or certain sounds
• Showing no interest in people and avoiding eye contact
• Difficulty in social interactions
• High pain threshold and lack of response to physical injury
• Language and speech difficulties
• Difficulty in expressing needs
• Absence of “pretend” playing
• Repetitive actions, such as rocking or pacing
• Difficulty in adapting to changes in routines
• Fixations on certain objects or activities
• Short attention span

The latest classification of autism spectrum disorders includes the following conditions:

• Asperger’s syndrome: The mildest condition in the autism spectrum featuring high functional and intellectual capabilities.
• Pervasive developmental disorder not otherwise specified (PDD-NOS): Children with PDD-NOS have more severe symptoms of autism than Asperger’s.
• Autistic disorder: Children with autistic disorder exhibit classic autism symptoms of an intense level.
• Childhood disintegrative disorder: The rarest and most severe end of the autism spectrum. These children may also have seizures.

The causes of autism spectrum disorders are not known. Imaging and other studies of brains of autistic individuals have revealed structural abnormalities in many regions of the brain. Though there is no conclusive evidence, scientists consider that one or a combination of the following are possible risk factors for ASD:

• Genetic factors: Though no specific gene has been identified to cause ASD, genetic abnormalities are thought to interfere with the brain development. Some genetic disorders that can cause autism or symptoms similar to autism include:
  • Rett syndrome
  • Fragile X syndrome
  • Tuberous sclerosis
  • Untreated phenylketonuria 
• Obstetric complications: Problems during pregnancy and delivery are a possible cause of ASD. Certain medical conditions, or medications taken during pregnancy are also thought to be risk factors for ASD.
• Infections: Many children with ASD born to women who contracted rubella during pregnancy suggests the possibility of infection as a risk factor.
• Toxic exposure: Exposure to toxins, chemicals and air pollution during pregnancy may affect fetal brain development, leading to ASD.
• Parental age: Some studies indicate that children born to parents (one or both) over the age of 35 may be at a higher risk for ASD.

Several population studies have demonstrated that there is no association between vaccinations and autism. It is recommended that parents adhere to the immunization schedule of children.

Studies have also disproved the earlier theory that ASD resulted from rejection by emotionally cold parents.

An early and individualized program of treatment that incorporates a combination of therapies is the most effective way to manage autism. Each type of therapy addresses a specific need of an autistic child. The therapies useful in managing autism spectrum disorders include:

Behavior and communication therapies

Applied Behavior Analysis (ABA)

Applied behavior analysis (ABA) is a widely used technique in schools and clinics for managing autism. ABA is used to discourage negative behaviors and help the child learn positive behaviors and improve a variety of skills. The different types of ABA include:

• Discrete Trial Training (DTT): Use of lessons broken down in simple parts with reward for positive responses.
• Early Intensive Behavioral Intervention (EIBI): Individualized approach with a trained professional to reduce negative behaviors such as tantrums, aggression and self-injury. EIBI is useful for children under 5 years of age.
• Early Start Denver Model (ESDM): An approach that uses play and joint activities to improve social, language and cognitive skills in children of 12 to 48 months.
• Pivotal Response Training (PRT): PRT is used to improve the motivation to learn, self-control and communication with others.
• Verbal Behavior Intervention (VBI): A program to teach verbal skills.

Picture Exchange Communication System (PECS)

This system is used to improve communication skills by teaching the child to use picture symbols in devices such as electronic tablets, to communicate.

Developmental, Individual Differences, Relationship-Based Approach

Known as “Floortime,” this approach involves getting on the floor and doing the activities the child likes. Floortime focuses on emotional development and the child’s response to sounds, sights and smells.

Treatment and Education of Autistic and Related Communication-handicapped Children (TEACCH)

Use of visual cues such as picture cards to teach the child everyday skills like getting dressed.

Occupational therapy

Occupational therapy teaches skills such as bathing, eating, dressing and relating to others, and helps the person to live as independently as possible.

Social skills training

Social skills training helps the children improve interaction with others and problem-solving.

Speech therapy

Speech therapy helps improve verbal communication skills, though, with some children, gestures and pictures may work better.

Physical therapy

Exercise and a regular program of activity may have therapeutic benefits.

Family therapy

Living with a person with ASD can be stressful for a family. Counselling the parents and siblings may be beneficial to the family and the person with ASD.

Changes in diet or certain supplements, vitamins and minerals are thought to have a beneficial effect for some children, though there is no evidence to support this theory. The doctor must be consulted before giving the child any alternate medication or supplements.

There are no medications to treat the primary behavioral symptoms of autism, but some medications may help in the management of some specific symptoms of autism. All children do not respond to medications in the same way, and each child must be closely monitored for any adverse effects from medications, especially when the person begins any new treatments.

Many medications are undergoing clinical studies for use in relieving ASD symptoms. Some of the commonly prescribed types of medications for autism include:

• Second generation antipsychotics
• Selective serotonin reuptake inhibitor (SSRI) antidepressants
• Stimulants
• Alpha-2 adrenergic agonists

There are only two FDA-approved medications for autism spectrum disorder (see following section). All other autism medications are used off-label by doctors to treat some specific symptoms of autism, because of beneficial results observed in studies or clinical practice.

Second generation antipsychotics

Antipsychotics work on certain chemical messengers (neurotransmitters) in the brain, known as dopamine and serotonin, which regulate mood, emotions and thinking. Following are the two second generation antipsychotics approved by FDA to treat irritability in autistic children:

• Aripiprazole (Abilify)
• Risperidone (Risperdal)

Other antipsychotic medications used off-label for serious behavior disorders in autism such as self-injury and aggression include:

• Ziprasidone hydrochloride (Geodon)
• Clozapine (Clozaril)
• Haloperidol decanoate (Haldol)

Selective serotonin reuptake inhibitor (SSRI) antidepressants

SSRI antidepressants are used for some autistic children to relieve anxiety. SSRIs increase the level of serotonin, a neurotransmitter that regulates mood. SSRIs prescribed for autism to manage aggression and repetitive compulsive behaviors include:

• Citalopram hydrobromide (Celexa)
• Escitalopram oxalate (Lexapro)
• Fluoxetine hydrochloride (Prozac)
• Sertraline hydrochloride (Zoloft)

Stimulants

Stimulants increase the level of two hormones, dopamine and norepinephrine, in the brain. Stimulants may be effective in treating hyperactivity and lack of attention in autistic children. An example of stimulants used for autism is:

• Methylphenidate hydrochloride (Ritalin, Quillivant XR)

Alpha-2 adrenergic agonists

Alpha-2 agonists inhibit the release of norepinephrine in the brain, which has a sedative effect and may be useful in managing hyperactivity, inattention and aggression in ASD. Alpha-2 agonists used for autism include:

• Clonidine hydrochloride (Kapvay, Catapres, Catapres-TTS skin patch)
• Guanfacine hydrochloride (Intuniv)

Warning: FDA warns that patients, particularly in the ages 18 to 24, who are prescribed antidepressants must be monitored for suicidal thoughts, especially during the first few weeks.

• Please visit our medication section of each drug within its class for more detailed information.
• If your prescription medication isn’t on this list, remember to look on MedicineNet.com drug information or discuss with your healthcare provider and pharmacist.
• It is important to discuss all the drugs you take with your doctor and understand their effects, possible side effects and interaction with each other.
• Never stop taking your medication and never change your dose or frequency without consulting with your doctor.