Medication for Autism Symptoms

UPI) -- An estimated one-third of youngsterswith autism are prescribed psychotropic drugs to control theirbehavior and outlook, scientists report.The more common pharmaceutical aids include anti-depressants likeProzac for anxiety and depression, stimulants like Ritalin forhyperactivity and impulsivity, anti-convulsants for seizures andanti-psychotic drugs, usually reserved for schizophrenia, foraggression.In certain cases, these medications can quell such behavioraloffshoots of autism as self-injury and severe tantrums, but they donot alter the underlying condition and can wreak havoc with somechildren's moods and pose other potential risks, doctors say."There is no great drug for autism," said Texas psychologist StevenGutstein, developer of a behavioral treatment called relationshipdevelopment intervention."Children with autism can have other problems that require medicationlike attentional problems or medical problems," he added. "It's acomorbid disorder, but there's no Ritalin for autism, and thereprobably never will be because it's a disorder with multipleetiologies."The drugs that are used are the same as those prescribed for similarsymptoms in children without autism, but doctors often find thedisorder affects the response, at times making the side effects muchmore pronounced or the medicine much less effective or both.Most of these pharmaceuticals are not backed by sufficient science tobe approved for such use, and the government acknowledges "much moreresearch is needed" to determine what risks they pose to children andadolescents over the long haul.The drugs' usual aftereffects may be so exacerbated in children withautism, health authorities urge doctors to give them the lowestpossible dose and monitor their reaction closely.In a rare study of drug treatments for minors with autism, sponsoredby the federal government, the anti-psychotic risperidone was foundto control tantrums, aggression, repetitive behaviors, severehyperactivity and/or self-injury for up to six months in childrenages 5 to 17.The survey of 82 boys and 19 girls, conducted at several U.S. medicalcenters, showed the medication -- which was donated by its makerJensen Pharmaceuticals -- produced only limited side effects.However, when the drug was discontinued, symptoms rapidly returned in62 percent of the cases.Because the study lasted only eight months, "our data may beinsufficient to estimate precisely the long-term risks of risperidonein children," the authors concluded.Although a variety of pharmaceutical and behavioral treatments isused to restrain violent behaviors in autistic youngsters, fewscientific studies have looked into their effects, the authors noted.Previously, the largest long-term studies of autism medicationstested haloperidol, an older anti-psychotic that proved light oneffectiveness but heavy on neurological and other ill effects.In another recent study, reported in the Archives of GeneralPsychiatry, researchers found methylphenidate, the No. 1 drug choiceof doctors treating attention-deficit/hyperactivity disorder, mayalso be effective for calming hyperactivity in children with autismspectrum disorders.There is a caveat, however, according to the Research Units onPediatric Psychopharmacology Autism Network, a consortium funded bythe National Institute of Mental Health, which conducted the study.The bad news is that the percentage of takers gaining benefits fromthe stimulants and the level of those benefits are lower, while thefrequency of unwanted effects scientists call "adverse events" ishigher in autistic children than in ADHD youngsters without thedisorder, the authors reported.Seven of the 72 participants ages 5 to 14 withdrew from the study dueto intolerable reactions to the drugs, including irritability, loss ofappetite, sleep problems, anxiety, depression, upset stomach,diarrhea, fatigue, self-injury and social withdrawal.Even among the children who could stomach the medicine, only halfshowed any improvement in symptoms, and it was modest at best, theresearchers said.Nevertheless, the authors deemed methylphenidate "a reasonable choiceto target hyperactivity in the context of PDDs (pervasivedevelopmental disorders)," although they warned caregivers to "becautioned about the strong possibility of adverse effects" andpractitioners to "be prepared to suspend treatment if considerableadverse effects are reported."Although no causative association has been proven, reports of someADHD children medicated with Ritalin and other stimulants sufferingstrokes and heart problems and seeing snakes and other hallucinationsprompted two federal regulatory advisory panels last year to urge thatparents and physicians be informed of the potential risks.The Food and Drug Administration has obliged, ordering drug makers torevise the labels for doctors and insert medical guides for patientsto alert them about the adverse cardiovascular and psychiatric sideeffects.Other researchers, experimenting on mice, have come up with a waythat may help alleviate the debilitating effects of Rett's disorder,a type of autism that primarily affects girls.The investigators found deactivating a certain gene produced therodent equivalent of the ailment, but turning it back on in animalspredisposed to the syndrome forestalled its onset. The researchclears the path toward developing therapies for humans, thescientists said.Some currently available treatments may ease certain symptoms, butthey fail to address the condition at a more fundamental level. Theresearchers from the Whitehead Institute for Biomedical Research inCambridge, Mass., and Brandeis University in Waltham, Mass., saidonce they learn the molecular mechanisms underlying the disorder,they may be able to design more effective strategies against it.(Note: In this multi-part installment, based on dozens of reports,conferences and interviews, Ped Med is keeping an eye on autism,taking a backward glance at its history and surroundingcontroversies, facing facts revealed by research and looking forwardto treatment enhancements and expansions. Wasowicz is the author ofthe new book, "Suffer the Child: How the Healthcare System Is FailingOur Future," published by Capital Books.)