Question
Our 8-year old son was recently diagnosed with Asperger's/ADHD. The psychologist said the next step is to meet with our family doctor to prescribe meds to help him be more successful in 3rd grade. While he is doing well academically, it takes him a couple of hours to complete 30 min. of homework every night, and he is having behavior problems in school. Are medications our only option to help him with behavior? He attends a private school which does not have a counselor, but the teacher and principal have been really working with us to help him function in class. This is very overwhelming for us-problems at school and our home life so stressful. Our parenting techniques we used on our first two sons definitely don't work with our Asperger son who is very defiant and rude. Yikes--where do we start?
Answer
There is no one specific medication for Aspergers (high-functioning autism). In some cases, specific target symptoms are treated with medication though (e.g., a stimulant for inattention and hyperactivity; an SSRI such as Paxil, Prozac or Zoloft for obsessions or perseveration and associated depression and anxiety; low dose antipsychotic such as risperidone for stereotyped movements, agitation and idiosyncratic thinking).
SSRI medications are selective serotonin reuptake inhibitors that are effective in treating many cases of anxiety and depression. The medicine may improve a few of the problematic symptoms of Aspergers including:
• Aggression
• Anxiety
• Depression
• Hyperactivity
• Impulsiveness
• Repetitive movements
• Self-injurious behaviors
• Self-stimulatory behaviors
Antipsychotic medications are also considered. Thought processes that are typical of Aspergers can be the source of great stress. Among the most stressful is transitioning and dealing with changes. Some behaviors result from thought processes that are obsessive in nature. The Aspie is unable to tolerate changes in routine and may become fixated on order. Antipsychotics alleviate the anxiety associated with obsessive thinking patterns and compulsive behavior. Other symptoms antipsychotic medications may address include:
• Idiosyncratic thought processes
• Irritability
• Repetitive movements
• Self-stimulatory behaviors
Common medications include:
- Abilify (This drug may be effective for treating irritability related to Aspergers. Side effects may include weight gain and an increase in blood sugar levels.)
- Celexa
- Intuniv (This medication may be helpful for the problems of hyperactivity and inattention in children with Aspergers. Side effects may include drowsiness, irritability, headache, constipation and bedwetting.)
- Lexapro
- Paxil
- Prozac
- Revia ( This medication, which is sometimes used to help alcoholics stop drinking, may help reduce some of the repetitive behaviors associated with Aspergers.)
- Risperdal (This medication may be prescribed for agitation and irritability. It may cause trouble sleeping, a runny nose and an increased appetite. This drug has also been associated with an increase in cholesterol and blood sugar levels.)
- Zoloft
- Zyprexa (Olanzapine is sometimes prescribed to reduce repetitive behaviors. Possible side effects include increased appetite, drowsiness, weight gain, and increased blood sugar and cholesterol levels.)
Other examples of alternative therapies that have been used for Aspergers include:
• Avoidance diets— Some parents have turned to gluten-free or casein-free diets to treat Aspergers. There's no clear evidence that these diets work, and anyone attempting such a diet for their child needs guidance from a registered dietitian to ensure the child's nutritional requirements are met.
• Melatonin— Sleep problems are common in kids with Aspergers, and melatonin supplements may help regulate your child's sleep-wake cycle. The recommended dose is 3 mg, 30 minutes before bedtime. Possible side effects include excessive sleepiness, dizziness and headache.
• Other dietary supplements— Numerous dietary supplements have been tried in Aspies. Those that may have some evidence to support their use include Vitamin B-6 and magnesium, Vitamin C, Carnosine, and Omega-3 fatty acids.
• Secretin— This gastrointestinal hormone has been tried as a potential treatment. Numerous studies have been conducted on secretin, and none found any evidence that it helps.
Other therapies that have been tried, but lack objective evidence to support their use include:
• antibiotics
• antifungal drugs
• chiropractic manipulations
• hyperbaric oxygen therapy
• immune therapies
• massage and craniosacral massage
• transcranial magnetic stimulation
COMMENTS:
• Anonymous said… Abilify worked great for us emotionally, but started giving him spasms after a few weeks (his dr. never saw it before so it was a rare reaction)...so look out for that.
• Anonymous said… According to ADHD experts 25% of kids actually have BVD (eyes out of sync), 1/3 Vitamin D deficiency, and 20% gluten intolerance. All things should be tested before a diagnosis of ADHD. My son was misdiagnosed for 5 yrs on meds when his strabismus (lazy eye) was causing double vision; we had no idea. VT is curing him (75% effective in curing BVD). Also 21 to 50% of autistic kids have BVD too like my autistic son. Symptoms have significantly improved. Son off of all meds, in VT, and getting vision accommodations www.covd.org
• Anonymous said… Also we went thru several meds before we found what worked. Prozac and Ritalin made our daughter so aggressive and moody. But Concerta (similar to Ritalin but longer lasting) helped her focus for school
• Anonymous said… CBD oil....hemp oil extract...proving wonders for many different illnesses.
• Anonymous said… Don't do the homework! Tony Attwood said autistic children should not do it and at only 8 there us overwhelming evidence that homework doesn't help a young child's education. Instead it is spoiling your family time and opportunities for enrichment. It would be better just to read together everyday.
• Anonymous said… For us and the family it's a godsend. I was at breaking point, my son was miserable and my husband has a disability. We couldn't cope any longer, if it was just the asd the courses I've been on I feel I could manage him. This ADHD is a whole added stress. I couldn't actually care less what people's opinions are as I know for a fact my son would be worse off without them.
• Anonymous said… get tested for magnesium deficiency and also epsom salt baths work great to help the kid sleep. There are directions on the back of the box, do atleast 2 baths a week for you child at night and you will see how relaxed they get.
• Anonymous said… I am sorry that your brother had such a difficult time and that you were there to witness it. There is so much more information now and medications that are better then what was available 30 years ago. Doctors now (at least good ones) look to find the right medication to open the potential for the child not make them zombies. I respect your opinion and I think you will make the right choice for your family. I just wanted to share with you what I have learned from having a Aspie with ADHD.
• Anonymous said… I am waiting to see specialist to get my 10 yr old aspie some meds but I'm a bit scared he'll be more aggressive than what he is already, but suppose we all have to go through this trial and error process, I just really hope what ever they prescribe works for him 1st time round
• Anonymous said… I do not believe in medicating Asperger's kids. You can't cure it with a pill. His issues can be managed and controlled with diet, and therapies.
• Anonymous said… I don't know what the oil is but agree on the meds. They are just to make it easier for others, not the child. Those pills damage the children and are related to many school shootings.
• Anonymous said… I have 2 boys with asd and my oldest has anger issues and adhd. We put him on a few different meds when he was 8 and diagnosed. The school as well as my family could not handle him any longer with out some kind of help. The dr gave him abilify, buspar and adhd meds. Last year they added intuniv also and it has helped. He has learned how to control some of his anger issues. A lot of it is just maturity and learning to cope with stressful situations. Oh and he is 14 now and is and has always been on the honor roll.
• Anonymous said… I have the same situation. I saw a dramatic change with ADHD by having him in a very strict gluten-free, coloring-free diet. Now about the aspergers there are not meds for that, therapies for social skills is a must. If the can't give him accommodations at school to help him you're in the wrong place. Drs and teacher love to have the kids in meds, regardless of side effects or even creating a dependence in stimulats. all I can say is you need to fight for him kneeling down an prayer and with this broken world.
• Anonymous said… i haven't seen any that specifically link the progression no. I have not really looked specifically for that. It's more of a feeling and question that I have. But, I have seen plenty that show the connection of the meds and drug addiction. With the studies showing the meds chemical equivalency to cocaine. Which makes me wonder if it can upset the chemicals in the brain causing further issues.
• Anonymous said… I just had a very bad experience with kids and meds. Not my son.. He has never been medicated...but with my brother. He was diagnosed ADHD at age 8 as well as gifted. His IQ was well above genius level. He was put on Ritalin. Then Wellbutrin. And others over the years ( this was in the late 80s and early 90s). He would go from being a zombie, to not being able to eat, to blowing up like a balloon with weight gain depending on the meds. Then after years on meds he had a diagnosis added at age 17. Bipolar disorder. Which by definition is a chemical in balance in the brain. It has always made me wonder if having such a young child on meds could have contributed to this imbalance. Then additional meds. At 26 a new diagnosis schizophrenia. While I can't know this is the cause… It does beg the question what exactly happens to a growing brain on such harsh chemicals.
• Anonymous said… I think every parent has to make a decision and we all are just trying our best. I just hope all will do more research because every child is worth it and can be helped without those harmful drugs. I'm not some anti vaccination mom, all anti meds, all natural type mom... I just know what these drugs can do and it's dangerous.
• Anonymous said… i understand but think what it may be doing to his brain chemistry long term. These kids have issues with brain chemistry already. Add in a drug that has a chemical equivalence to cocaine and what could that do? I am not judging you. It just worries me.
• Anonymous said… I was very much anti meds for several years. I finally caved and it was disasterous. My daughter went from having meltdowns to every single sing being exagerated. Her sensory system was completely over stimulated all the time and there was nothing that we ciuld do to help her. We tried several different types of medication and stopped. When off meds, She continued to do worse in school. She couldnt complete her assignments and really kept falling furth and further behind. And having daily drawn out meltdowns because she couldnt keep up with the other kids. I got a new pediatrician and spoke to her about what was happening. Her response was that we had one more medication that we could try. She said not to get our hopes up because nothing else had worked. My daughter is happy now. Her meltdown have been cut in half. She went from full time special ed. to having two main stream classes. Her behavior has improved. Her communication skills have improved slightly Etc. Her father and I feel so relieved not because she can concentrate, but because she doesnt have to fight with it any more. Life is sincerely easier for her. My son tried his first medication at the same time my daughter started hers. He is doing amazing. It was the first medication that she ever tried and it made her crazy. It takes time to find the right medicatio. With the proper dosage but once you do, it can be a life saver, not only for you and others who are trying to help your child, but also for your child. Medications are not you're only option though. You can try to curb the behavior and try to teach him to pay attention. You can also try an ABA therapist and see if they can't help as well.
• Anonymous said… I'm curious about your brother's experience and his evolving diagnosis. My brother also had/has sever ADHD, was medicated from a young age and now has emotional disorders, mainly depression. My husband also has ADHD and has been on and off medication over the years. Now my son who has ADHD/ASD is for the first time on meds after trying diet and supplements for years with no success. It is like a miracle to have him do his school work and participate in activities without getting distracted every millisecond but I worry about the long term effects. The docs always assure me that it is safe but I wonder...DO you have any information/studies to confirm the link you suggest between long term medication use and further imbalance? TIA
• Anonymous said… I'm just curious do you have an autistic or aspergers child? Or a child with adhd? How about a non verbal autistic child with O.C.D and a.d.h.d? I am not for drugging children up to the point their just physically there
• Anonymous said… my ASD/ADHD child did very well on Abilify as well. However, after several months and having to raise her dosage, she started to have excessive blinking of her eyes she could not control, like a tic. It is suppose to be a very rare side effect.
• Anonymous said… My Aspie/ADHD son has been taking Straterra , a non-stimulant, since he was 5 without any major side effects. He was monitored for growth, sleep, eating- no issues. He is now 18. He did have a low dose of Buspar when having anxiety transitioning into middle school, but only for a short time. I would suggest keeping things simple- one task at a time, fully explaining what, how, and why. Positive reinforcement with a chart also gives them concrete goals.
• Anonymous said… My daughter does not do well without meds. She is completely miserable and unable to function without them, and makes everyone else around her miserable./exhausted. With meds she is able to enjoy so much more of her life, at school, with friends, taking music lessons etc. She is happier and she has told me so. She still has many challenges, but the meds bring her to a level where she can work through them better. Meds were very scary at first, but they were a life saver for us and I will never regret giving my daughter a chance to have the best childhood she can.
• Anonymous said… My daughter is the same, aspergers, bad behavior and takes forever to do hw, we got her an iep but docs say no to meds because she is already on a drug to prevent seizures. I honestly think a med wont fix it, Kids like this see the world differently and we need to accommodate them and work with them instead of fighting them and trying to normalize them. So no, I don't agree about meds. Ask your doctor about magnesium, possibly have him tested for vitamin deficiencies, you may do this privately through a naturopath as well if the doctor wont, you can also do it privately yourself, there are several online testing centers that work with labs in your area to receive this type of testing. Also try epsom salt baths at night and see if they relax your son.
• Anonymous said… My oldest does not bring home school work anymore. He does it in the school only. Too much anxiety and it was torture. No need to do that to him.
• Anonymous said… My son has ASD/ADHD as well and takes methylphenidate xr. Tge medication does affect his appetite (he only eats breakfast willingly, and snack, the rest of the meals he needs prompting), but it's like we turned his brain on. Homework that used to take hours to accomplish can be done in 30 mins or less most days. Unfortunately, due to the overlap in inattentive symptoms between ASD and ADHD you'll only ever be able to manage the ADHD side of things with meds. For the inattention that comes from Asperger's you'll need to find other ways to motivate your child. Does your kiddo have a special interest? See if you can work his interest in to his homework. Check out the book "Just Give Him the Whale" it has lots of suggestions on how to use a special interest to motivate an Aspie. Good luck! Remember, this is hard but you're not alone.
• Anonymous said… My son has Aspergers and is on methylphenidate. He has never had any side effects and as a result functions extremely well with no support in school. There are side effects with all sorts of drugs. If he had epilepsy, would you not give him anti seizure medication? It's the same principle, if it gives him a fighting chance to live a good life, it has to be tried. If he reacts badly then you go back to the drawing board. Good luck to you and your family xx
• Anonymous said… My son is now 17 and a senior in high school. I feel we were in the position as you. He was diagnosed asperger's/adhd. He refused to take a pill, so they gave us a patch called Daytrona. It enabled him to focus at school and get through his homework.
• Anonymous said… My son takes medication and it helps some but not always. We tried abilify as well but that didn't work at all and made him gain 20 lbs!
• Anonymous said… my son was the same. We've tried every ADHD med & Concerta had the least side effects for him but then he became aggressive on it. As soon as we stopped it, the aggressiveness went away. His psychiatrist who also has Asperger's explained to me that ADHD meds work differently in their brains than they do in Neuro typical brains. 😟
• Anonymous said… My sons on methylphenidate and I can hand on heart say it's saved our family! I tried everything else and please do what you feel is right. If you want to try meds do it.
• Anonymous said… Not all children can be "managed and controlled" with diet and therapy. Stop being so simplistic about this on everyone's comments. There are children who need medication and those who don't. Thankfully your child must not be one who needs it.
• Anonymous said… Not everyone's Asperger's child is the same. They are all "somewhere" on the spectrum. The symptoms one child is experiencing may not be what another child is experiencing.
• Anonymous said… Seriously no meds! Please look up about those medications. They have found that those meds only harm children by destroying parts of the brain.
In cases of school shootings, do your research, because those are typically always cases of kids who once we're forced to take those meds. I once knew a kid who was forced on those. While he did better at focusing, his grades didn't change. All he did was become a robot for the damn school. He became boring, still lacked friends, and his artistic talent? GONE!! Completely washed away. When he turned 16, he started lying about the meds and not really taking them. After a few months, he started drawing again and actually being a happy teen. Sadly though, he has a lot of issues because of those damn pills! This story is not to scare anyone but it's truth!
• Anonymous said… So many people treat us parents who Medicate like child abusers! But for us, we were at rock bottom and my eldest sons was getting hit at etc due to his impulsiveness of his ADHD. I'm not abusing my son I'm helping him regulate his moods until he's able to himself.
• Anonymous said… The key to medicating is finding the right medication in the correct dose. A lot of times the first, second and even third medication doesn't work so people give up. Medication should never cause child to "veg out" nor should it cause extreme emotions. My son tried many medications. Just the difference between a regular and extended release version of the same med can be like night and day. My son is not just Dx with Aspergers. He deals with Mood disorder, OCD, anxiety, seasonal depression and insomnia. Prior to medication at 5 & 6 years old he was trying to get out of the car on the freeway and running away from me and across busy streets after meltdowns.
• Anonymous said… The wristband is to help with their focus issues. It vibrates so that your child stays on track. What I've learned is that when my son feels confident (doesn't get behind in class, gets better grades, teachers aren't annoyed bc they have to stay on top of him), that his all around attitude is better. Maybe the teachers mean no harm, but kids can pick up on their body language and know when he/she is frustrated with them. And if your child is like mine, anybody who is frustrated at them automatically hates him, thinks he's a jerk, thinks he's stupid, a bad kid, etc... It's expensive but, in my opinion, it's worth it to see my child succeed.
• Anonymous said… Vyvanse really helped my son (for ADHD). It lasts all day, well into evening for doing homework. Also, you don't have to worry whether school personnel gave it or not. Seroquel XR in the evening helped with other behaviors. Both have significant effects on the body, but with the help of a specialist school for Aspergers as well, my son has graduated from high school and is trying college. Natural supplements include calcium/magnesium/zinc/vitamin D and Nordic Naturals fish oil. No one regimen is ideal for any child and no parent wants their child on "drugs". It was also necessary to try a lot of different medications before the ideal combination was reached. You will love it when your son voluntarily does homework by himself and voluntarily apologizes for a temporary lapse into rude behavior or back talk. Best wishes to you, all parents and children.
• Anonymous said… We are dealing with this exact problem. We started abilify this week. I keep praying it is going to relieve his symptoms.
• Anonymous said… We found out several years after our son's ADHD diagnosis that he also had three learning disabilities that was the reason why he was still struggling in certain areas. Once the ADHD has been addressed it might be worth checking out LDs if there's still struggles with academics.
• Anonymous said… We had the patch on my daughter, it worked well. On in early am, off at dinner. You have to monitor sleep and eating- it is a stimulant.
• Anonymous said… We have gone back & forth with meds. Anxiety adds to the autism/ADHD diagnoses we received. We do use a med to help her fall asleep and stay asleep because she is a wreck otherwise. We requested school accommodations - reduced assignments, extra time for both assignments & tests, and the ability to re-do or retake for additional credit.
• Anonymous said… we started with mainly dietary. Put him on the GAPS diet for a while and now he eats no processed foods. Additionally he takes supplements that help brain function. We limit screen time to one hour per day. He is in cognitive and occupational therapies. He takes melatonin at night to help him sleep. He has done so well on this protocol. It's like I have a different child.
• Anonymous said… With the same diagnosis (albeit it's the Adult form of ADHD; I was only diagnosed as being with it at 36), I'm currently on Strateras (100 Mg; increased after my most recent consultation from 80 Mg) also known as Atomoxetines or Atomoxetine Hyrochloride (1 Daily) as well as Rivotrils .5 Mg Tablet (4 a Day; 1 + 1 + 2) as well as Zolpidems (a benzo I think?) to help me sleep which I only take if or as reqd. Am "enjoying" reading the Status Updates & replies as a result of my belated diagnosis (no fault lies with my Psychiatrist by the way; Aspies weren't a thing when I was growing up in Southern Ireland & ADHD kids were just seen as easily bored/distracted who couldn't concentrate and/or were troublesome. I managed to control it in a lot of cases (though plenty times I didn't in hindsight!) & manage it when I had a routine. Never thought I'd be grateful for being a blue-collar working class employee but looking back now I'm so glad I was & had that routine to keep me together.
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