What Medications Are Used for FASD?

Eight types of drugs that may be useful for symptom control in people with fetal alcohol spectrum disorders (FASDs) include:

1. Stimulants:
   • Stimulants (methylphenidate and amphetamine derivatives) are first-line drugs used to treat attention deficit hyperactivity disorder (ADHD) symptoms common in children with FASDs, such as hyperactivity, inattention, and impulsivity. 
   • Because of the organic brain damage nature of FASDs, stimulants have varying effectiveness when used to treat these symptoms in people with FASDs.
2. Alpha-2-adrenergic agonists:
   • Non-stimulant therapies for ADHD, such as clonidine and guanfacine, may help lessen the “fight or flight” reaction to anxiety in disinhibited youngsters.
   • Alpha-2-adrenergic agonists may aid in the treatment of related issues such as attention deficit, hyperactivity, and impulsivity, as well as in the reduction of tics.
   • Because alpha-2-adrenergic agonists can have drowsiness as a side effect, they should be avoided during the day although they can be beneficial for children who have trouble sleeping.
3. Selective norepinephrine reuptake inhibitors:
   • Non-stimulant therapies such as selective norepinephrine reuptake inhibitors (atomoxetine) can be used to treat ADHD symptoms when stimulants are ineffective.
4. Anxiolytics:
   • Anxiolytics (such as buspirone) can be used to alleviate anxiety symptoms that are frequent in children with FASDs.
5. Antidepressant medications:
   • Antidepressant medicines (sertraline and fluoxetine) can be used to treat depression symptoms such as sadness, lack of interest, sleep disturbances, and anxiety.
6. Neuroleptics:
   • Neuroleptics (such as risperidone or aripiprazole) can be used to treat severe symptoms including aggressiveness, anxiety, disruptive behavior, and impulsivity.
   • The most prevalent adverse effect of neuroleptic treatment is considerable weight gain, dry mouth, blurred vision, and abnormal movements.
7. Melatonin:
   • Melatonin (a hormone produced by the pineal gland) supplementation may aid with sleep issues. Children with FASDs may have aberrant sleep patterns (parasomnias and insomnias) and an altered melatonin profile.
   • As a result, certain children with FASDs and sleep problems may benefit from melatonin administration to aid with sleep start. 
   • Before prescribing melatonin supplements, physicians may highlight the importance of established nighttime rituals and environments, including comfortable bedding, temperature, and clothes, as well as having a familiar, secure, and predictable sleep environment.
8. Choline:
   • Choline might be used as a neurodevelopmental intervention for a child with FASDs.
   • Scientific evidence has supported the favorable effect of choline on nonverbal IQ, visual-spatial abilities, verbal memory, and working memory in children aged two to five years with FASDs.
   • Few studies reported that choline-treated children had fewer ADHD symptoms than the placebo group.
   • Researchers found that choline might be a useful supplement to a child's overall treatment of FASDs.

Medications are not the first line of treatment for FASDs; however, they can be used in combination with behavioral and environmental/family treatments to address FASD comorbidities such as:

• ADHD
• Depression
• Anxiety
• Aggression
• Sleep disturbances

Fetal alcohol spectrum disorders (FASDs) are avoidable birth abnormalities and intellectual and neurodevelopmental problems that result from maternal alcohol consumption during pregnancy.

FASDs are a collection of physical, mental, and social issues induced by alcohol exposure in the uterus during pregnancy. When a mother consumes alcohol during her pregnancy, it can travel from her blood to the fetus through the placenta, impairing the baby's growth and brain development.

Depending on the nature of symptoms, several labels are used to characterize FASD variants such as:

• Fetal alcohol syndrome (FAS): It is the most severe form of FASD.
  • Symptoms may include:
    • Small wide-set eyes
    • Philtrum (the smooth ridge between the top lip and nose)
    • Thin upper lip
    • Hyperactivity
    • Cognitive difficulties
    • Learning problems
    • The trouble with social connections
    • Delayed neurodevelopment
    • Reduced fine motor abilities
    • Poor eye/hand coordination
    • Sensitive to light and sound
• Alcohol-related neurodevelopmental disorder: It typically results in intellectual disabilities.
  • Symptoms may include:
    • Problems with behavior and learning
    • Impairments in memory, attention, judgment, and impulse control
• Alcohol-related birth defects: They lead to congenital abnormalities that can include problems with the
  • Heart
  • Kidneys
  • Skeleton
  • Vision
  • Hearing
• A neurobehavioral disorder associated with prenatal alcohol exposure: Symptoms may include
  • Cognitive and memory impairment
  • Behavior problems such as severe tantrums or mood issues
  • Social problems
  • Impairment in daily living skills

Children and adolescents with alcohol-related neurodevelopmental disorder, alcohol-related birth defects, and neurobehavioral disorder do not typically exhibit physical characteristics associated with FAS, but they do exhibit learning and behavioral difficulties that have a significant effect on home and school life, as well as social relationships.

Fetal alcohol syndrome is caused by alcohol entering the bloodstream of an unborn child, which occurs when a pregnant mother consumes alcohol.

When a woman consumes alcohol during her pregnancy, some of it crosses the placenta and enters the fetus. Because a fetus's liver cannot metabolize alcohol like that of an adult, alcohol can produce several negative effects on the unborn kid.

The presence of alcohol in a fetus can:

• Damage to healthy cells causes aberrant development.
• Impair nerve cell development.
• Slow blood flow to the placenta, depriving the fetus of oxygen and nourishment.

Toxic alcohol by-products harm the brain of the fetus.

Many of the physical symptoms of fetal alcohol syndrome (FAS) last throughout adulthood. These effects, however, may be less noticeable in adults than in youngsters.

FAS physical symptoms that continue throughout adulthood frequently include:

• Short stature
• Small head size
• Thin upper lip
• Reduced brain size
• Problems with attention, distraction, learning, and memory
• Decision-making and planning problems
• Externalizing problems, such as aggression
• Internalizing problems, such as depression, anxiety, social anxiety, and obsessive-compulsive disorder
• Depression 
• Psychotic symptoms
• Anxiety 
• Bipolar disorder

Unfortunately, there is no known cure or therapy for newborns born with fetal alcohol spectrum disorders (FASDs). Their physical, mental, and behavioral deficits usually last a lifetime. However, if detected early, experts, family, and friends can minimize the severity of some symptoms.

• A child with FASDs may benefit from the following services:
  • A multidisciplinary team of experts, including an occupational therapist, a special education teacher, a psychiatrist, and a speech therapist
  • Medical care/specialists (speech-language pathology, physical therapy, mental health care, etc.)
  • Behavioral and educational therapy
  • Parent training
  • Alternative approaches (auditory training, creative art therapy, meditation, etc.)
  • Special services are available in elementary and secondary schools to assist students with learning and behavioral issues
  • Medication to alleviate certain symptoms
• You and your spouse might benefit from the following services:
  • One-on-one counseling to aid you in coping with any FASD-related challenges that your family may be experiencing.
  • If you feel that you may have difficulty restricting your alcohol usage, treatment is available to you.
  • Parenting workshops will assist you and your lifestyle choices and avoid future pregnancies being damaged by alcohol intake.
• Some protective factors can help reduce the effects of FASDs and assist people with these problems in reaching their full potential:
  • Early diagnosis
  • Involvement in special education and social services
  • Loving, nurturing, and stable home environment
  • Absence of violence
• Preventive measures for FASDs:
  • FASDs can be avoided if no alcohol is ingested during pregnancy. It's particularly vital to avoid consuming alcohol if you're trying to get pregnant or suspect you're pregnant.
  • If you learn that you were drinking after conception, notify your doctor and discontinue drinking immediately.
  • There is no safe amount or type of alcoholic beverage to consume during pregnancy, and there is no safe timing to consume alcohol.
  • FASDs are diagnosed by carefully examining a child's physical traits, development patterns, and learning strengths and deficits. 
  • Undiagnosed, the activities of people affected by FASDs are frequently misinterpreted, misdiagnosed, and mistreated as a behavioral condition, resulting in further trauma.

There is still work to be done to educate the public about the dangers of prenatal alcohol consumption. The enormous numbers of individuals who have already been affected by FASDs deserve medical attention and assistance to live successful lives and contribute to society.