Medications for Autism
The Food and Drug Administration (FDA) has approved two drugs for treating irritability associated with the autism (risperidone and aripiprazole). The prevalent behavioral problems associated with autism spectrum disorder, including repetitive behavior, communication, and social issues, have not been able to be improved by medication at this time, since there are no drugs are currently approved to address these core symptoms.
However, a breakthrough may be on the horizon. A major Swiss pharmaceutical company, Roche, says it has received a designation from the Food and Drug Administration to help expedite what could be the first drug to treat these core characteristics of autism. Roche released news in January 2018 that the FDA has granted its breakthrough therapy designation for the development of balovaptan, a drug that potential to improve “core social interaction and communication” in those with autism. Results from a clinical trial in adults with autism released in 2017 indicate that balovaptan was successful in helping to improve challenging social behaviors. Additionally, it was deemed safe and well tolerated.
Another trial looking at children and adolescents on the spectrum is underway and additional studies are in the works. Improving these problems could help a person with autism spectrum disorder function more effectively in all areas of their lives. However, risperidone and aripiprazole can actually ease these core symptoms, because relieving irritability often improves sociability while reducing tantrums, aggressive outbursts and self-injurious behaviors.
Both risperidone (Risperdal) and aripiprazole (Abilify) were approved by the Food and Drug Administration (FDA) for autism-related irritability. These two drugs are in a class known as atypical antipsychotics and are believed to produce better results than previously used “typical” antipsychotics. In addition to addressing irritability, these drugs also may reduce behaviors such as aggression, deliberate self-injury, and “lashing out” or temper tantrums. The drugs address these behaviors about 30 to 50 percent of the time, but don’t address all behavior issues — and psychiatric problems are common in children with autism.
Other atypical antipsychotics that have been studied recently with encouraging results are olanzapine (Zyprexa®) and ziprasidone (Geodon®). Ziprasidone has not been associated with significant weight gain, though some side effects of these medications can include increased appetite and weight gain. It is important to consult with your doctor to monitor these side effects, and also make a commitment to a healthy diet and exercise.
The medications used for autism spectrum disorder may be used to treat similar symptoms in other disorders. Many of these medications are prescribed “off-label.” This means they have not been officially approved by the U.S. Food and Drug Administration (FDA) for use in children, but the doctor prescribes the medications if he or she feels they are appropriate for your child. Further research needs to be done to ensure not only the efficacy but the safety of psychotropic agents used in the treatment of children and adolescents.
Olanzapine (Zyprexa) and other antipsychotic medications are used “off-label” for the treating symptoms such as aggression in addition to other serious behavioral disturbances in children, including children with autism. Other medications are used to address symptoms or other disorders in children with autism. Fluoxetine (Prozac) and sertraline (Zoloft) are approved by the FDA for children age 7 and older with obsessive-compulsive disorder. Fluoxetine is also approved for children age 8 and older for the treatment of depression.
Two SSRIs, Fluoxetine and Sertraline, have been approved by the FDA to treat obsessive compulsive disorder (OCD) in children who are also diagnosed with autism spectrum disorder. Fluoxetine has been used to treat children with major depressive disorder (MDD) and OCD for over 14 years in the USA, has recently been expanded to other behavior disorders, including attention deficit hyperactivity disorder (ADHD), anxiety, and autism. Sertraline was approved by the FDA for children age 7 and older with obsessive-compulsive disorder. Despite the relative safety and popularity of SSRIs and other antidepressants, some studies have suggested that they may have unintentional effects on some people, especially adolescents and young adults.