Medicines and autistic children
Medicines can sometimes help autistic children, particularly when children have behaviour, emotional and learning challenges that interfere with their:
- health and wellbeing
- ability to learn and progress
- daily life or family life.
For example, doctors might recommend medicines if autistic children are self-harming or harming others.
The right medicines for autistic children depend on children’s needs.
Therapies and supports that make the most of autistic children’s skills are key to children’s development. If you and your child’s GP or paediatrician decide that medicine might also help your child, this will be just one part of the overall approach to supporting your child’s development.
Who to talk to about medicines for autistic children
It’s important to get professional advice about medicines. Professionals like your child’s GP, paediatrician or psychiatrist can help you weigh up the benefits for your child against possible risks.
Make sure to ask your child’s doctor about:
- why they recommend a medicine
- what the medicine does
- what the appropriate dose is
- what the side effects are.
When you’re choosing a professional for your autistic child, look for someone who has experience working with autistic children. And it helps if it’s someone you trust and someone who knows your child.
Benefits and side effects of medicines for autistic children
Medicines might be prescribed to help autistic children with:
- aggressive behaviour
- anxiety and obsessive behaviour
- hyperactive behaviour or overactivity
- sleep problems
Risperidone can help to reduce aggressive behaviour in autistic children. It belongs to a group of medicines called atypical antipsychotics.
The side effects of atypical antipsychotics include:
- increased appetite
- weight gain, which can sometimes be quite noticeable
- tiredness or drowsiness
- increased heart rate
- stiff arms or legs, or jerky movements that children can’t control.
Anxiety and obsessive behaviour
Selective serotonin re-uptake inhibitors (SSRIs) might help to reduce anxiety and obsessive and repetitive behaviour, although more research is needed.
The side effects of SSRIs include:
- hyperactive or impulsive behaviour
- nausea and stomach ache
- sleep difficulties
- concentration problems
- irritable or restless feelings
- appetite changes.
Teenagers and grown-ups can experience sexual dysfunction with SSRIs.
SSRIs have a possible link to suicidal thoughts. If your child is taking SSRIs, it’s important to pay close attention to their behaviour, emotions and moods.
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 tasks for longer and think more before they act.
The main side effect of these medicines 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:
- increased repetitive movements
- stomach ache
- sleep disturbance
- withdrawal from family and other people
- irritability or emotional ups and downs.
Some autistic people have seizures. Some autistic children have a lot of seizures, and some are diagnosed with epilepsy.
Seizures can usually be treated effectively with anti-epileptic medicine. There are many anti-epileptic medicines, and the best one for your child depends on the type of seizures your child has. It also depends on any other difficulties your child has or other medicines they’re taking.
Different anti-epileptic medicines have different side effects. Common side effects include:
- behaviour changes
- nausea and stomach ache.
Your circadian rhythm is your 24-hour body clock. It helps to control when you fall asleep, how long you sleep and when you wake up. Melatonin, a hormone produced in the brain, helps to control your circadian rhythm.
When melatonin is used as a medicine, it 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.
Several medicines can help to reduce tics. These medicines include atypical antipsychotics and noradrenergic agents.
The side effects of antipsychotics and noradrenergic agents include:
- weight gain
- increased appetite
- increased heart rate
- involuntary tremors
- tiredness or drowsiness
- dry mouth.
Some medicines are ineffective and/or harmful for autistic children. These include adrenocorticotrophin hormone (ACTH) and naltrexone.
Starting a new medicine: things to discuss with the doctor
Before your child starts a new medicine, check with your child’s doctor about whether the medicine suggested has been tested with autistic children. Also check whether it has been tested with children your child’s age.
Not all medicines work in the same way for all children, so it can take a few tries and visits to the doctor to find a medicine and dose that works for your child.
Often a medicine needs to be taken in a certain way to be effective. Talk to your child’s doctor about when and how often your child needs to take it, and whether it should be with or without food.
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 have child-resistant locks.
How to know whether a medicine is helping your autistic child
When your autistic child starts taking a new medicine, you and your child’s doctor need to monitor your child carefully.
Before your child starts the medicine, it can help if you understand what behaviour or difficulty the medicine is supposed to help with. 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.
If you record these details before your child starts a new medicine, you’ll be able to see whether anything is changing after your child starts the medicine.
When your child starts taking a medicine, try not to change anything else about their routine or therapy program. Then if you see any changes, it’ll be easier to tell whether they’ve been caused by the medicine. You could also ask a family member or a family friend if they notice any differences in your child’s behaviour.
Talk with your child’s doctor about any changes.
Don’t stop a medicine suddenly, even if you think it isn’t helping your child. This is especially important if your child has been taking a medicine for a long time. Always talk to your child’s doctor about stopping a medicine.