Monday, February 19, 2018

What About Medication?

Ever since DS1 was diagnosed with ADHD in Grade 3 someone has asked me why we don't medicate him. His recent ASD (Autism Spectrum Disorder) diagnosis, the questions are coming again.

As parents, it falls squarely on our shoulders to do our best by our kids. We are both well-educated and my skills as a Librarian (my degree is a "Master of Information") allow me to research topics very thoroughly and discern the best sources.

Whether a parent has chosen to medicate their child with ADHD or ASD or not is a personal matter for them to decide with their partner or support system. This post is to explain how we arrived at our decision. I am not a medical professional, so please do your own due diligence in making your own decision.

After weighing the pros and cons, we chose not to medicate for ADHD. Our child did not seem to be "suffering" and our family doctor and the pediatric specialist we saw did not push us down the medication road.

With ASD, it actually became even clearer to us that not medicating was the right decision. It turns out that there aren't any drugs that are specifically for the core communication, social, and repetitive behaviour issues of ASD.

There are many articles that address this:

What Drugs Are Used for Treating Autism?, Applied Behavior Analysis, undated [emphasis mine]:
>>This task [detailed and specific regimens that have to be followed] can be more frustrating because there are currently no approved drugs available to treat the core communication, social, and repetitive behavior issues so commonly associated with autism. All prescriptions currently available simply work at the periphery of the real problems or otherwise represent doctors’ attempts to treat those conditions experimentally. Further, the common practice of prescribing a mixed cocktail of different medications for ASD has not been put through clinical trials. Many common drug combinations remain untested.


Understanding more about the types of medications that an ASD patient may be on can be important to both caregivers and therapists since both the capabilities and side effects of the drug may dramatically alter a person’s behaviors. There is also increasing concern, particularly with children on the spectrum, that the effects of psychotropic medications taken during the formative years can permanently stunt brain development.

Almost all of the drugs also have common side effects such as:

  • Diarrhea and other stomach irritation
  • Rashes, hives, and itching
  • Dry mouth
  • Fatigue
  • Weight gain


<<

Medicines for Autism, WebMD, November 20, 2015 [emphasis mine]:
>>Medicines have a limited role in improving symptoms of autism.


There is no standard medicine for the treatment of autism. 

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. 

But these medicines [haloperidol, risperidone, and thioridazine] can have side effects, including sleepiness, tremors, and weight gain. Their use is usually considered only after behavior management has failed to address the problem behaviors.<<

We are currently using ABA (Applied behaviour analysis) at home and it will be in place at school shortly so it is premature to be looking at medication.


Medicines for Treating Autism’s Core Symptoms, Autism Speaks, undated [emphasis mine]:
>>Medicines for treating autism are most effective when used in conjunction with behavioral therapies. Ideally, medicines are a complement to other treatment strategies. 

Medicines for treating the three core symptoms of autism – communication difficulties, social challenges and repetitive behavior – have long represented a huge area of unmet need. Unfortunately, few drugs on the market today effectively relieve these symptoms and none of the options most often prescribed by practitioners work well for every individual.


In fact, while the Food and Drug Administration (FDA) has approved two drugs for treating irritability associated with the autism (risperidone and aripiprazole), it has yet to approve a medicine for treating autism’s three core characteristics.<<

Autism's Drug Problem, Scientific American, April 24, 2017 [emphasis mine]:
>>Clinicians are particularly concerned about children with the condition because psychiatric medications can have long-lasting effects on their developing brains, and yet are rarely tested in children.

“Psychotropic medications are used pretty extensively in people with autism because there aren’t a lot of treatments available,” says Lisa Croen, director of the Autism Research Program at Kaiser Permanente in Oakland, California. “Is heavy drug use bad? That’s the question. We don’t know; it hasn’t been studied.”

No existing medication treats the underlying condition.

The core characteristics of autism include repetitive behaviors, difficulty with social interactions and trouble communicating. Therapy can help, but no medication so far can improve these problems. Instead, drugs merely treat some of the peripheral features — ADHD, irritability, anxiety, aggression, self-injury — that make life challenging for people with autism.<<

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