Autism and behavioral problems
Navigating the best options for your autistic child is not an easy task and can become overwhelming. One of the options parents begin to look at are medications. Autism does not have an explicit medication, but medications exist for symptoms. This makes it so that 30-60% of youth with autism receive some type of medication for managing aggression, irritability, hyperactivity, and other problem behaviors (Logan, 2012). One of the reasons parents choose for their children to take medication is because of behavioral problems that can come with autism. Some of these can include tantrums, aggression, or self-harming.
Every parent of an autistic child has their own unique experiences. As many of you know, autism is a neurodevelopmental disorder that presents itself through repetitive behaviors, difficulty with social interactions, behavioral issues, and more. Though there are many shared symptoms when it comes to autism, it is a spectrum. This means that children experience the core symptoms to different magnitudes. Some of the children will experience behavioral issues to an extreme extent that can potentially be self-harming and aggressive. As a parent, your number one concern will always be your child's safety, so searching for any possibility to decrease the likelihood that it will be threatened is something important to you. Today I will present to you two options that have been researched and tested.
What is most important is to find what works best for your family and most importantly, your child's needs. Seeing what your child goes through is emotionally tolling, but medicating is not the only option and it can come with impactful side effects. One thing vital to this is balancing the needs and the potential effects. For that reason, I want to speak about two possible options and the symptoms that can come with each. One of these drugs is one of the only FDA-approved drugs for autism symptoms and the other is an option that experts continue researching: supplementing a vitamin that is very common for autistic children to be deficient in.
All about the FDA approved atypical antipsychotic drug
These potentially harmful behavioral problems have been a concern for experts in the field. The first thing scientists did was look at drugs that have been effective for other disorders. Among them, the atypical antipsychotic drug, risperidone was found. These drugs relieve symptoms of psychosis which includes symptoms of incoherent or nonsense speech, and behavior that is inappropriate for the situation. The mechanisms of this drug may enhance its efficacy and provide protection against involuntary movements. It has been seen that risperidone reduces the irritability of autistic children and has very effective short-term results (McCracken, 2002).
When was it FDA-approved?
The safety of any drug your child could potentially take is something important, so it is great news that the use of risperidone in autistic children was approved in 2006 for children of ages 5 and older.
Does the drug have long-term effects?
Studies are also suggesting that risperidone could have long-term results. This was researched in a study where it was found that half of the children who took the drug relapsed much less in disruptive behavior such as aggression, self-injury, tantrums, agitation, and unstable moods (Troost, 2005). These children had been taking risperidone for 16 weeks and these measurements were recorded for the 6 months after taking the drug.
What are the side effects?
Something important to consider is the side effects and whether they will only add to your child's troubles and make things worse rather than better for them. Studies have found that a major side effect of risperidone was weight gain.
The side effects in a short term study
In the short-term study of risperidone, it was found that 49% of the children taking this drug experienced a mild increase in appetite and 24% a moderate increase in appetite (McCracken, 2002). With this, there was weight gain seen. Other side effects seen in this study were fatigue, drowsiness, dizziness, and drooling.
The side effects in a long term study
In the long-term study, two patients withdrew due to weight gain. The average weight gain of the children was 6 kg (Troost, 2005). Other side effects seen were anxiety and fatigue.
It is important to consider if this drug is truly something that is necessary for the life of your child. Although it is a quick solution to many behavioral problems, many times, intervention is something that works just as well and does not come with any side effects. I know that it can become something draining and difficult, but there are so many options and I hope that learning about them will assist you in finding the best option for your child. If you want to learn more about intervention methods and how these can help your child, here are some resources for you:
https://online.regiscollege.edu/blog/behavior-intervention-definition-strategies/
https://www.cdc.gov/ncbddd/autism/treatment.html#Behavioral
What do autistic people have to say about risperidone?
As a non-autistic person, my opinion or input will never outweigh that of an autistic person. In this blog written by James Ward-Sinclair, he speaks on how the drug often drained him but that it would act quickly on his aggressive symptoms. James also speaks on how it oftentimes put him to sleep and he would awake with that anger still lingering. James also mentions how weight gain is a potential side effect that he did not experience, but that it could have been something that would negatively affect him. If you are interested in reading more about what he experienced and his own perspective on using the drug, here is the link:
Vitamin D and autism
Vitamin D deficiency is a common trend among autistic children. In the body, vitamin D plays an important role in supplying a relatively stable brain balance, developing the nervous system, immune system, and gene regulation (Kerley, 2017).
Vitamin D supplemented alone
When vitamin D was used alone in research, it was found that there was mostly improvement when it came to the self-care (eating, dressing, and sleeping) of the children but not as much as there could have been for treating these behavioral issues (Kerley, 2017). Other studies think that they did not find effective results because of the trial duration lasting 20 weeks and the lack of accumulative dose over time.
Vitamin D supplemented with a dietary compound
A separate study lasting a year found improvements in the irritability of children when vitamin D was used alone. This study also supplemented vitamin D with a compound essential for a healthy diet: omega-3 LCPUFA. When this was done, the vitamin D supplement performed better and lowered the irritability of these children even more. Omega-3 LCPUFA is found in fatty fish such as salmon, tuna, mackerel, herring and sardines, and fish oil. This shows great signs of vitamin D supplementation towards the reduction of extreme behavioral issues in autistic children (Mazahery, 2018).
What are the overall side effects seen?
When this research was done there were no adverse effects noted. This is something great to hear, although the two studies mentioned contradict each other, there are potential reasons as to why the first was not as effective. There is still research being done to better establish its effectiveness.
Next Steps
For your final decision-making, please consult your doctor and take into account the information provided to you if you found it helpful. I am very glad I was able to introduce each of these drugs to you.
Works Cited
Kerley CP, Power C, Gallagher L, Coghlan D. Lack of effect of vitamin D3 supplementation in autism: a 20-week, placebo-controlled RCT. Arch Dis Child. 2017 Nov;102(11):1030-1036. doi: 10.1136/archdischild-2017-312783. Epub 2017 Jun 16. PMID: 28626020.
Logan, Sarah L et al. “High prescription drug use and associated costs among Medicaid-eligible children with autism spectrum disorders identified by a population-based surveillance network.” Annals of epidemiology vol. 22,1 (2012): 1-8. doi:10.1016/j.annepidem.2011.10.007
Mazahery H, Conlon CA, Beck KL, Mugridge O, Kruger MC, Stonehouse W, Camargo CA Jr, Meyer BJ, Jones B, von Hurst PR. A randomised controlled trial of vitamin D and omega-3 long chain polyunsaturated fatty acids in the treatment of irritability and hyperactivity among children with autism spectrum disorder. J Steroid Biochem Mol Biol. 2019 Mar;187:9-16. doi: 10.1016/j.jsbmb.2018.10.017. Epub 2018 Oct 26. PMID: 30744880.
McCracken JT, McGough J, Shah B, Cronin P, Hong D, Aman MG, Arnold LE, Lindsay R, Nash P, Hollway J, McDougle CJ, Posey D, Swiezy N, Kohn A, Scahill L, Martin A, Koenig K, Volkmar F, Carroll D, Lancor A, Tierney E, Ghuman J, Gonzalez NM, Grados M, Vitiello B, Ritz L, Davies M, Robinson J, McMahon D; Research Units on Pediatric Psychopharmacology Autism Network. Risperidone in children with autism and serious behavioral problems. N Engl J Med. 2002 Aug 1;347(5):314-21. doi: 10.1056/NEJMoa013171. PMID: 12151468.
Troost PW, Lahuis BE, Steenhuis MP, Ketelaars CE, Buitelaar JK, van Engeland H, Scahill L, Minderaa RB, Hoekstra PJ. Long-term effects of risperidone in children with autism spectrum disorders: a placebo discontinuation study. J Am Acad Child Adolesc Psychiatry. 2005 Nov;44(11):1137-44. doi: 10.1097/01.chi.0000177055.11229.76. PMID: 16239862.