Medicines have a limited role in improving symptoms of
autism. But some may help prevent self-injury and
other behaviors that are causing difficulty. Medicines may also take a child to
a functional level at which they can benefit from other treatments.
There is no standard medicine for the treatment of autism. The American
Academy of Pediatrics (AAP) suggests targeting the main one or two problem
behaviors when considering medicines.1
Medicines that are sometimes used to treat behaviors related to autism
include selective serotonin reuptake inhibitors (SSRIs) and antipsychotic
medicines.2
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) include citalopram
(Celexa), fluoxetine (Prozac), and sertraline (Zoloft, Lustral). The high rate
of effectiveness for depression, anxiety, and obsessive, stereotypical
behaviors has made these medicines a popular choice for managing autism. They
may also improve general behavior, language, learning, and socialization. In
addition, although SSRIs have side effects, such as weight gain, insomnia, and
increased agitation, they tend to be less serious than those of antipsychotic
medicines.
FDA advisory. The U.S. Food and
Drug Administration (FDA) has issued an
advisory on antidepressant medicines and the risk of
suicide. The FDA does not recommend that people stop using these medicines, but
they do recommend that people who use these medicines be watched for
warning signs of suicide. This is especially important
at the beginning of treatment or when the dosage is changed.
Antipsychotic medicines
Antipsychotic medicines,
such as haloperidol (Haldol), risperidone (Risperdal), and thioridazine work by
changing the effects of brain chemicals. They may help decrease problem
behaviors that can occur with autism. A well-designed study found that
risperidone was effective for the treatment of tantrums, aggression, and
self-harming behavior in children with autism.3, 4
But these medicines
can have side effects, including sleepiness, tremors, and weight gain. Their
use is usually considered only after behavior management has failed to address
the problem behaviors.
Other medicines that are sometimes used include:2
- Clonidine (Catapres) and guanfacine hydrochloride
(Tenex). These medicines are typically used to lower blood pressure but are
also used to treat impulsive and aggressive behaviors in children with autism.
- Lithium (Eskalith, Eskalith-CR, Lithobid, Lithonate, Lithotabs)
and anticonvulsants, such as carbamazepine (Carbatrol, Epitol, Tegretol) and
valproic acid (Depakene). Children who are occasionally aggressive may become
more stable when using these medicines, although monitoring the level of the
drug in the body through regularly scheduled blood tests is required.
The effectiveness of these medicines varies by individual.
Side effects are possible and should be discussed with your doctor. Some
doctors may advise going off a medicine temporarily, in order to identify
whether it is having a positive or negative effect.