Difference between revisions of "Prescription Medication"

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===Stimulants===
 
===Stimulants===
  
Controlled studies suggest that there is an elevated risk of adverse events such as confusion, possible psychosis, and treatment emergent tic disorder occurring for children with ASD who take stimulants than typically developing children with other disorders including ADHD.  Studies involving children with ASD to test the safety and efficacy of stimulants in this population show a much higher dropout rate than for the typically developing population.  Reasons cited for dropping out are usually from negative mood effects.  Additionally, children with ASD report a higher rate of insomnia in studies when taking medium ( 0.25 mg/kg/dose) and high doses (0.5mg/kg/dose) as well as a reduction in appetite.  
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Controlled studies suggest that there is an elevated risk of adverse events such as confusion, possible psychosis, and treatment emergent tic disorder occurring for children with ASD who take stimulants compared to typically developing children with other disorders including ADHD.  Studies involving children with ASD to test the safety and efficacy of stimulants in this population show a much higher dropout rate than for the typically developing population.  Reasons cited for dropping out are usually from negative mood effects.  Additionally, children with ASD report a higher rate of insomnia in studies when taking medium ( 0.25 mg/kg/dose) and high doses (0.5mg/kg/dose) as well as a reduction in appetite.  
 
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Some suggestions for management in this population include extended-release preparations for medications rather than those that are rapidly releasing.  Patients prescribed stiumulants should be monitored closely for side effects using a structured measure, such as growth in height.  If growth drops off too quickly, the clinician should reconsider using stimulants. 
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Some suggestions for management in this population include extended-release preparations for medications rather than those that are rapidly releasing.  Patients prescribed stiumulants should be monitored closely for side effects using a structured measure, such as growth in height.  If growth drops off too quickly, the clinician should reconsider using stimulants.
  
 
===Second Generation Antipsychotics===
 
===Second Generation Antipsychotics===

Revision as of 14:07, 11 March 2009


Papers List | Variables List

Prescription Medication

Description

A variety of prescription medication is commonly prescribed by clinicians to treat various symptoms such as depression, repetitive behaviors, epilepsy, psychosis in ASD children. Many safety and efficacy studies are underway for this population, though most clinicians say that from experience those with ASD tend to have side effects more often and of a more severe nature than the typically developing population.

Antidepressants

Antidepressants should be used with with increased caution for children with ASD because of the current FDA warning for increased suicidal thinking and behavior for children taking antidepressants, as well as the tendency for children with ASD to experience side effects more frequently and more severely than the typically developing population. Usually, antidepressants prescribed are serotonin selective re-uptake inhibitors (SSRIs). Side effects include nausea, sedation, activation, agitation, insomnia, and sometimes increased activity, increased anxiety, or mood lability. ASD children tend to have greater disinhibition when taking antidepressants. Activation also happens more frequently in ASD children (one study had a 20% activation rate among ASD subjects).

The best management strategy to avoid activation in this population is to use the lowest effective dose and to slow the titration schedule (much less than the schedule used in adults).

Medications which have neurological side effects such as Clomipramine should be used with caution in ASD patients because children with ASD may be at higher risk to experience neurological side effects since many in this population also suffer from seizures.

Stimulants

Controlled studies suggest that there is an elevated risk of adverse events such as confusion, possible psychosis, and treatment emergent tic disorder occurring for children with ASD who take stimulants compared to typically developing children with other disorders including ADHD. Studies involving children with ASD to test the safety and efficacy of stimulants in this population show a much higher dropout rate than for the typically developing population. Reasons cited for dropping out are usually from negative mood effects. Additionally, children with ASD report a higher rate of insomnia in studies when taking medium ( 0.25 mg/kg/dose) and high doses (0.5mg/kg/dose) as well as a reduction in appetite.

Some suggestions for management in this population include extended-release preparations for medications rather than those that are rapidly releasing. Patients prescribed stiumulants should be monitored closely for side effects using a structured measure, such as growth in height. If growth drops off too quickly, the clinician should reconsider using stimulants.

Second Generation Antipsychotics

Adverse effects from using second generation antipsychotics include sedation, increased appetite, weight gain, disrupted sleep, prolactin elevation, and extrapyramidal symptoms. However, some side effects such as sedation seem to fade with time. Low doses appear to be highly effective from studies and they also tend to have a lower risk of side effects than higher doses.


References

1. McCracken, J.T. Safety issues with drug therapies for Autism Spectrm Disorders. Journal of Clinical Psychiatry 2005; 66 (suppl 10).