What are cholinergic agents?
The brain has multiple systems that regulate thinking. One key system involved in learning, short-term memory and arousal is the cholinergic system, which uses a neurotransmitter called acetylcholine to send signals.
Cholinergic agents are medicines that increase the amount of acetylcholine in the brain, which might affect the parts of the brain involved in learning, short-term memory and attention.
Some of the medicines used as cholinergic agents include galantamine, rivastigmine and donepezil.
Who are cholinergic agents for?
Cholinergic agents are routinely used for people with Alzheimer’s disease.
These medicines might also be used for autistic people and people with ADHD.
What are cholinergic agents used for?
When cholinergic agents are prescribed for autistic people, the aims are to:
- help them feel less irritable
- improve their speech
- reduce their aggressive behaviour and hyperactive behaviour.
Where does cholinergic agent therapy come from?
In the early 1900s, scientists discovered that our bodies use natural chemicals called neurotransmitters to send signals to our muscles and organs. From the 1930s to the 1950s, researchers made synthetic versions of these neurotransmitters to mimic or enhance their actions in the body and brain.
As medicines, these synthetic neurotransmitters were helpful for treating some conditions, including Alzheimer’s disease.
More recently, researchers have looked at whether these medicines are safe and effective for autistic people.
What is the idea behind cholinergic agent therapy for autistic children?
If areas of the brain are low in acetylcholine, cholinergic agents can be used to stimulate acetylcholine in the brain and improve how the brain works.
The use of cholinergic agents for autistic people is based on the idea that autism characteristics might be related to low acetylcholine. But there’s no clear evidence that this is the case.
What does the use of cholinergic agents involve?
This therapy involves taking medicine or applying a patch to the skin. The specific medicine and dosage depend on people’s symptoms.
People taking cholinergic agents need close monitoring and must attend regular check-ups to see whether they’re experiencing benefits or side effects.
Does cholinergic agent therapy help autistic children?
There’s limited evidence that cholinergic agents have any benefit for autistic children, and there’s also some evidence that they might cause harm. Side effects are common, and we don’t yet know how these medicines affect autistic children in the long term.
Also, most autism studies have involved older children and teenagers, so we know very little about effects in younger children.
Because of this, cholinergic agents aren’t usually recommended as a first treatment option for autistic children. Other approaches are usually tried first.
Who prescribes cholinergic agents?
GPs, paediatricians or psychiatrists can prescribe cholinergic agents and give you information about the potential benefits and risks of using them.
Where can you find a doctor who prescribes cholinergic agents?
If you’re interested in cholinergic agents, see your GP, a paediatrician or a psychiatrist.
You can find psychiatrists by going to Royal Australian and New Zealand College of Psychiatrists – Find a psychiatrist.
How are parents involved in cholinergic agent therapy for autistic children?
If your child is using cholinergic agents, you need to ensure that your child takes the medicine as prescribed. You also need to closely monitor the effects of the medicine, especially for side effects.
How much do cholinergic agents cost?
The cost of this therapy varies depending on the brand of medicine used and its dose or strength. It also depends on whether the medicine is covered by the Pharmaceutical Benefits Scheme (PBS) and whether you hold a concession card like a Health Care Card.
Therapies and supports for autistic children range from behavioural therapies and developmental approaches to medicines and alternative therapies. When you understand the main types of therapies and supports for autistic children, it’ll be easier to work out the approach that will best suit your child.