Medications for autism & autistic children

About medications for autistic children

Medication is not a ‘cure’ for autism. But medication can sometimes help with the behaviour and other difficulties that some autistic children experience.

In these cases, the appropriate medication depends on the difficulty that’s interfering most with children’s daily lives, and also how severe the difficulty is.

Early, family-based therapies and supports that emphasise learning work best for young autistic children. If you and your child’s GP or paediatrician decide that a certain medication might be suitable for your child, it’s important to think of it as part of the overall approach to supporting your child’s development.

When to consider medications for autism

Decisions about if and when to try medications can be hard. You need to weigh up the benefits for your child against the possible risks.

For example, you might consider talking to your child’s GP or paediatrician about medications if your child is self-harming or harming others. Or you might consider medications if a characteristic or condition is very severe or hasn’t responded to other approaches.

Who to talk to about medications for autistic children

Medications that affect children’s minds or how they’re feeling are usually prescribed by a paediatrician or child and adolescent psychiatrist. Sometimes a GP might also prescribe these medications.

When you’re choosing a professional, look for one who has experience working with autistic children.

Medications: how they can help autistic children and what their side effects are

Medication might be prescribed to help autistic children with characteristics like:

Before deciding whether medication is right for your child, it’s important to talk with your child’s doctor about what the medication does and what its side effects are.

Aggressive behaviour
Risperidone can help reduce aggressive behaviour in autistic children. It belongs to a group of medications called atypical antipsychotics.

The side effects of atypical antipsychotics include:

gaining weight, which can sometimes be quite noticeable
feeling sleepy or tired
drooling.

Less common side effects include:

stiff arms or legs, or jerky movements children can’t control
changes in a hormone called prolactin, which can cause breast development and milk secretion
changes in how children’s livers are working, how many fats they have in their bodies, and how their bodies control blood sugar levels.

Anxiety and obsessional behaviour
Selective serotonin re-uptake inhibitors (SSRIs) can help reduce anxiety. These medications can sometimes also reduce children’s obsessional behaviour, although more research is needed into how well these medications help with repetitive behaviour.

The most common side effects of SSRIs are:

tummy troubles (sick feelings and tummy pain)
trouble sleeping
irritable or nervous feelings.

Teenagers and grown-ups can experience sexual dysfunction with SSRIs.

Recently doctors and scientists have started to worry that people taking SSRIs might think about hurting or even killing themselves, particularly if they’re younger than 25. If these feelings happen, it’s almost always within the first couple of weeks of starting the medication, so you need to watch your child carefully during this time.

Hyperactive behaviour
Stimulants like Ritalin and Concerta are prescribed to help children with attention deficit hyperactivity disorder (ADHD). They can also reduce hyperactive behaviour in some, but not all, autistic children. This might allow children to concentrate on a task for longer and think more before they act.

The main side effect of these medications is lower appetite. This can mean that children using them might not gain enough weight, or might even lose weight.

Other possible side effects include:

irritability
tics
more repetitive behaviour
more anxiety
more hyperactive behaviour.

Seizures
Up to one-third of autistic people have seizures at some stage in their lives. Some autistic people have a lot of seizures. Some autistic children will be diagnosed with epilepsy.

Seizures can usually be treated effectively with anti-epilepsy medication. There are many different anti-epilepsy medications, so the best one for your child depends on the type of seizures your child has. It also depends on any other problems your child has or other medications they’re taking.

Side effects vary with different anti-epilepsy medications. Common side effects include:

sleepiness
behaviour changes
tummy troubles.

Sleep problems
Melatonin maintains your circadian rhythm, which is your internal 24-hour clock. Your circadian rhythm helps to control when you fall asleep, how long you sleep and when you wake up.

Melatonin can help people who have trouble sleeping – for example, because of jet lag or shift work. It can also help with sleep difficulties in autistic children.

Side effects of melatonin include nausea and headaches.

Tics
Several different medications can help reduce tics. These medications include atypical antipsychotics and noradrenergic agents like clonidine. Clonidine can also help lower hyperactive behaviour.

The side effects of antipsychotics include:

gaining weight
drooling
feeling tired or sleepy.

The side effects of clonidine include feeling very sleepy. People might also experience low blood pressure or heart rate. Clonidine is also very dangerous if your child takes too much.

Medicines are the most common cause of poisoning in young children. To prevent poisoning, store medicines up high in a locked cupboard, safely out of reach and out of sight of your child and other children. The cupboard should be at least 1.5 m high and should have child-resistant locks.

Assessing whether a medication works

When your child starts taking a new medication, you and the professional need to monitor your child carefully.

It can also help if you understand the targeted behaviour or problem before your child starts the medication. Take a week to write down details like when, how often and how long the behaviour happens, and think about how intense it is. Also pay attention to your child’s sleeping habits and appetite. This puts you in a good position to notice whether anything is changing once your child starts the medication.

When your child starts taking a medication, try not to change anything else about their routine or therapy program. Then if you notice any changes, it’ll be easier to tell whether they’ve been caused by the medication. You could also ask a family friend it they notice any differences in your child’s behaviour.

Other things to consider and discuss with your doctor

Check with your doctor about whether the medication suggested has been tested with autistic children.

Not all medicines work in the same way for all children, so it can take a few tries and visits to your doctor to find a medication and dose that works for your child.

Often a medication needs to be taken in a certain way to be effective. Talk to your doctor about when and how often your child needs to take it, and whether it should be with or without food.

Don’t stop a medication suddenly, especially if your child has been taking it for a long time. Always talk to your doctor about stopping a medication.

Some medications are ineffective and/or harmful for autistic children. These include adrenocorticotrophin hormone (ACTH) and naltrexone.