Wednesday, December 19, 2007

Autism and Aspergers medication considerations

Because we don't have medications that directly affect the actual root cause of autism and Aspergers we target symptoms and treat them accordingly. Sometimes the results can be surprisingly good and at other, modest at most. The key is to find the most appropriate medicine with the least side effects. The following are my first choices, based on effficacy and side effects. There are other options but these are my favorites.

For aggression:
Antipsychotics: all are ok, look at the ones with less side effects: Abilify, Seroquel have less side effects, other may cause weight issues (Risperdal and Zyprexa) and Geodon can have cardiac conduction issues
Anti-seizure meds: Trileptal, Depakote(watch for weight gain) and Topamax (watch for cognitive/memory decline)

For perseveration:
SSRI's: Prozac, Luvox-don't use SSRI's if there is a family history of bipolar
Inosital-be patient, stick with it, it may take 6 weeks to see results, don't be afraid to push up the dose to high doses

For hyperactivity and inattention:
Focalin-xr, Adderall-xr-both can be sprinkled if swallowing issues exist
Clonidine, though potentially too sedating has been surprisingly good for some kids
Consiider Provigil, especially if the stimulants not helpful

Don't over look the benefits of a casein-free diet! Casein is the fat in milk. It can be great for many kids, especially if there has been a history of colic and intolerance to milk as an infant.

Don't overlook the benefits of a sensory diet and OT interventions! Having an outpatient OT to guide you in your management at home can be invaluable. You may need to push your insurance carrier to cover it and you may need to ask your pediatrician or child psychiatrist to give you an order for it.

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