Medicines for autism

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) 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.

The U.S. Food and Drug Administration (FDA) has issued a warning on anticonvulsant medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take anticonvulsant medicine should be watched closely for warning signs of suicide. People who take anticonvulsant medicine and who are worried about this side effect should talk to a doctor.

Citations

  1. Myers SM, et al. (2007). American Academy of Pediatrics clinical report: Management of children with autism spectrum disorders. Pediatrics, 120(5): 1162–1182.
  2. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5): 1–18.
  3. McCracken JT, et al. (2002). Risperidone in children with autism and serious behavioral problems. New England Journal of Medicine, 347(5): 314–321.
  4. U.S. Food and Drug Administration (2006). FDA approves the first drug to treat irritability associated with autism, risperdal. FDA News. Available online: http://www.fda.gov/bbs/topics/NEWS/2006/NEW01485.html.

Last Updated: May 19, 2008

Author: Jeannette Curtis

Medical Review: Michael J. Sexton, MD - Pediatrics & Fred Volkmar, MD - Child Psychiatry

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