Medical management of Autism
Management of autism is multimodal. As 75% of children are found to have mental retardation educational interventions are important. As there is a delay in language development, speech therapy is necessary for improvement of outcome. Sensory integration and social skills training are some of the other methods used.
Medical management is also one of the modalities of treatment. While it is not curative, it helps to control symptoms especially of irritability, hyperactivity and self injurious behaviour. These symptoms may also interfere with other modalities of treatment and hence require treatment.
Different classes of medications are used like:
Antipsychotics are classified as typical and atypical. Typical antipsychotics like haloperidol are not preferred unless there are severe treatment resistant symptoms due to their adverse effect profile. There are 2 atypical antipsychotics approved for autism by the US FDA i.e. Risperidone is advised to reduce stereotypic and repetitive behaviuors and aripiprazole is advised to reduce irritability in children with autism.
Antidepressnts like clomipramine, sertraline, mirtazapine and escitalopram are used to reduce symptoms like aggression, self injurious behaviour, repetitive behaviour, anxiety, and irritability and increase social relatedness.
Alpha 2 antagonists like clonidine and guanfacine are advised to reduce hyperactivity, anxiety, impulsivity and inattention.
Stimulants and non stimulants:
Methylphenidate is an example of stimulant medication used in children who are hyperactive and have difficulty maintaining attention and concentration. Atomoxetine is an example of Non stimulant medication used in children who are hyperactive.
Valproic acid is used to treat children with autism. This medication helps reduce aggression and repetitive behaviour in children with autism.
Amantadine, donepezil, tetrahydrobiopterine, rivastigmine are some of the other drugs used in autism.
One has to keep in mind that though autism may not be curable, there are multiple options to control the symptoms and improve the quality of life. Medicines reduce the distress caused by the symptoms, reduce their interference in daily activities and will help you manage your child better. Depending on the symptoms of each child, a comprehensive individualized treatment program with a combination of drugs can be charted out. Once the medications are started, parents should closely watch for any side effects. You should be well informed about the possible side effects and ways of managing them. Symptomatic improvements and effectiveness will be noticed if medications are consumed appropriately as prescribed by your doctor. If you still find that they are not working, speak to your doctor about an alternative drug or dosage. Stay in constant touch with your doctor for monitoring the benefits and the side effects at regular intervals.