How medication can help and hurt the symptoms of autism

My penchant for interest in scientific study regarding medication is not relagated to vaccine therapy. Blind studies are imperative for all pharmaceuticals and how they are prescribed.

A article in the Naturalnews.com SSRIs Prescribed for Autistic Children Make Them Worse highlights the recent criticism about the drug Celexa and SSRI being utilized to diminish repetitive behaviors in autistic adolescents and teenagers:

"Bryan H. King, M.D., of Seattle Children's Hospital and the University of Washington, Seattle, and his research team set out to find evidence about how the SSRI might affect those with autism. The scientists conducted a randomized controlled trial to document the safety and efficacy of citalopram in children with autism spectrum disorders who had moderate or higher levels of repetitive behavior. Out of a group of 149 research subjects with autism spectrum disorders between the ages of 5 to 17, 73 were randomly assigned to receive citalopram (taking a typical average maximum dosage of 16.5 milligrams per day). Another control group received an inactive placebo for 12 weeks.

After the three month treatment period was over, the scientists could find no improvement in the group treated with citalopram when compared to the kids in the placebo group. However, there were differences in the two groups of youngsters -- the ones on the SSRI had far more problems after taking the drug than the kid who didn't. In fact, instead of halting repetitive movement, citalopram actually increased a form of repetitive movement."

Our personal adventure into the medication world was a roller coaster ride, one that I would like to share:

Temple Grandin, noted professor and authority on autism, is also diagnosed with autism herself and her interview about the efficacy of medication is truly worth reading. Dr. Grandin is thoughtful, as well as thought provoking regarding her approach to living with autism. I heard her speak over fifteen years ago, and her message has never altered pertaining to the fact that medication saved her life. “I would not be here now if I did not have anti-depressants.”, she says, but clearly cautions about side effects as well as complications.

Approximately ten years ago we grappled with the idea of medication for our ten year old son with autism. Our primary focus was to eradicate some of his obsessive behavior, the “movie in his mind” which I addressed in my colum on obsessive compulsions.

We wavered for nearly two years as to whether anti-anxiety drugs or anti-depressants would help our son. A psycho- pharmacologist advised us to consider how much the behaviors were impacting his life, in essence our lives.

Ultimately we chose to try medication. Our journey via SSRIS (selective serotonin re-uptake inhibitors) Zoloft, Luvox & Paxil was unsuccessful. Serotonin is a brain neurotransmitter that is responsible for well being and positive mood. Various SSRI medications were reported to prove useful in lessening repetitive thoughts. Unfortunately they were not valuable in our case. The doctor suggested we try Anafranil, a tricyclic anti-depressant, which was verified to be successful with true obsessive compulsive disorder cases.

Anecdotally, we saw an augmented aggressive behavior during this period, consequently, the doctor recommended to add risperdal, initially used for anti-psychotic acute schizophrenia. Various studies involving this drug have reported positive results for adolescents with autism. The combination with anafranil and risperdal was an abysmal failure, in our case.

Our dear sweet beautiful boy morphed into a tortured adolescent and we could not determine why. Was it puberty? Was it medication? It was not until I spoke with a director I interviewed at a residential school who asked me what medication our son was taking. When I responded she shared with me that she saw significant negative behaviors with Anafranil. Mind you, she was not a doctor and neither am I, but she offered valuable information. Data and anecdote is all we have to rely on, and I was willing to wean him from the drug. We continued with the risperdal for a short time coupled with seroquel (a psychotropic medication used for mania and bipolar disorders). Eventually our journey came to an end, when a camp nurse suggested (off the record) to take him off everything and see what happened.

Four years passed. His agonies and erratic behavior faded, however the
“movie in his mind” is hard to suppress totally. When he was sixteen, a parent shared with me that Abilify helped her daughter. Abilify is used for bipolar disorder, and believed to adjust dopamine in the brain, therefore affecting serotonin.

It took another year before we were willing to try another medication. We were weary and intimidated, yet the one hook that grabbed us was when this mother said “Abilify got rid of some of the weird stuff”. That intrigued us. Currently, after taking Abilify for nearly two years, he is a calm and relatively happy human being. Did it obliterate his autism? No. Did it eradicate his obsessive conversation? Not completely. Is it better? Yes.

Our ultimate test was last winter when I was concerned about the side effects related to Abilify. Tremors are a consideration. I took our son to a neurologist for testing. It proved to be negative. One evening, our son seemed particularly anxious. I asked him if he was taking his Abilify. He replied no, because I had said it might be causing a problem. I was unaware that he had overheard me calling the doctor. Ironically, it was an inadvertent blind study. He agreed to start taking the Abilify again, and to reiterate, it appears to “take the edge off” at this time in his life.

What does Temple Grandin, and my son have in common? Autism. How time and evidence has treated the disease is a work in progress. Does medication help? Perhaps, trial and error is too great a task in specific individuals. The operative question remains: How much do the behaviors impact your child's life? It is only then can you make and informed decision about medication for autism.