Is There Effective Medication For Asperger’s?
By Abigail Boyd
Updated August 30, 2019
Reviewer Dawn Brown
Asperger syndrome is a developmental disorder that affects the structure and function of the brain. Children and adults with Asperger's have difficulty with social interactions, establishing and maintaining peer relationships, and processing sensory stimuli. While Asperger's is often diagnosed during childhood, as more awareness is being spread about autism spectrum disorders, more adults are receiving an Asperger syndrome diagnosis.
Managing Asperger's can sometimes be a struggle and takes a multidisciplinary approach. If you're currently establishing treatment, you may be wondering if medication for Asperger's is an option. Many children and adults with Asperger's take some kind of medication as a part of their care. In a 2013 study of children on the autism spectrum, 64% used psychotropic medication, and 35% were on more than one at the same time.
The neurochemistry and nervous systems of people with autism spectrum disorders may be more sensitive to medications, in ways that are not completely known yet. In general, medications must be tailored to the individual's needs and response. All medications must be monitored closely for side effects and adjusted accordingly.
The choice to involve medication in you or your child's treatment is a personal decision that should be made after educating yourself about the benefits and risks. Behavioral interventions and therapy should always be the first line of treatment, but medication can be a helpful adjunct for certain patients. It's crucial to find a doctor that is experienced in prescribing medication to individuals on the spectrum and up-to-date on the latest research.
Some people prefer to avoid medication altogether in favor of alternative treatments. It's also just as valid to explore whether or not medications can assist you. Educate yourself, speak to your doctor, and weigh the pros and cons, and then decide whether or not pursuing medication is right for you or your child.
What Medications Are Available For Asperger's?
There are only two medications approved by the FDA to treat behavioral issues in patients with ASD: the antipsychotics aripiprazole and risperidone. There are no other medications currently available to treat the core symptoms of Asperger's, such as socialization and communication difficulties. We're still learning about the exact cause of autism spectrum disorders and how the brains of those born with these conditions function. Preliminary research has suggested differences in the amygdala, prefrontal cortex, and other brain structures.
Despite this, medications are frequently prescribed for comorbid conditions, such as ADHD, anxiety, and depression. Treating these conditions allows for more effective management of the central symptoms and may even reduce their impacts, such as increasing sociality and reducing repetitive behaviors and obsessive thoughts.
The following three classes of medication are those most commonly prescribed for patients with Asperger's and other ASDs. This includes Asperger syndrome in adults and children.
Atypical antipsychotics were developed to treat certain mood and mental disorders such as schizophrenia and bipolar disorder while reducing the risk of side effects compared to first-generation antipsychotics. As previously mentioned, two antipsychotics are the only ones specifically approved for treating ASD symptoms, specifically, irritability, aggression, and self-injury. Research has shown this class of drugs to be fairly effective at treating these symptoms in up to 50% of cases.
Atypical antipsychotics are thought to work by blocking certain types of dopamine receptors in the brain that can contribute to negative symptoms. Depending on the mechanism of action for each particular drug under this umbrella, there may be other effects. While the risk of side effects is lower than with first-generation antipsychotics, it is still present. These adverse effects include weight gain, movement disorders, and fatigue, and the chance of developing one or more of these issues gets higher as the dose increases.
Therefore, as with any medication, antipsychotics should be prescribed with caution and maintained at the lowest possible effective dose.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs have been some of the most commonly prescribed medications for patients on the autism spectrum for decades. These medications have been shown to be effective for depression and anxiety, common conditions among patients with Asperger's. anxiety, in particular, can be crippling, especially for those diagnosed later in life. Untreated, these conditions may develop into a barrier that leaves the individual feeling chronically stuck, isolated, and unhappy.
SSRIs include Paxil, Prozac, and citalopram, among others, and work by preventing the reuptake of the neurotransmitter serotonin in the brain. Research has shown SSRIs may help to regulate mood, reduce repetitive behaviors, and increase socialization to a certain extent.
While SSRIs can be very effective for some people, that's not the case for others. As with any medication, there's also a risk of side effects, including headaches, nausea, and restlessness. More significant cases of autism spectrum disorder may not benefit from SSRI treatment.
Asperger's and ADHD have a strong association, as ADHD is present in as many as 50-80% of children and adults on the spectrum. This layer of symptoms, including hyperactivity, difficulty focusing, and impulse control issues, can create additional difficulty when attempting to treat the core symptoms of Asperger's itself. Stimulant medication has shown to be extremely effective in reducing and controlling ADHD symptoms.
Stimulants fall into two main categories: methylphenidates (Ritalin, Concerta) and amphetamines (Adderall, Vyvanse). Both work to treat ADHD symptoms by increasing the amount of dopamine and norepinephrine available in the prefrontal cortex, the area of the brain responsible for executive functioning.
Some people, particularly children, may be sensitive to the risk of side effects with stimulants and should be monitored closely. Side effects could include an increase in hyperactivity and motor tics. These almost always stop when the medication is eliminated, so there is a very low risk when trialing these medications.
Getting Started With Medications
Before you or your child begins any medication, you and the doctor should establish clear goals and expectations for treatment. It's important to have realistic expectations for what each medication can do. Determine what symptoms you're hoping to reduce or eliminate and establish a baseline before you begin. Do you want to decrease anxiety? Improve hyperactivity? Reduce repetitive behaviors? Clearly outline the symptoms you're targeting and understand how the medication is supposed to treat them. Be realistic and specific.
Monitor progress throughout the initial treatment phase so that you can be sure you're seeing the response you're aiming for. You may find it helpful to track this information on your phone or in a notebook. Be sure to share your findings with the doctor and any other members of the medical team.
Familiarize yourself with the potential side effects of any new medication. If you notice any of these or other new symptoms, contact the doctor's office right away. The dosage may need to be reduced, or the medication changed for an alternate option. Never stop the medication abruptly unless instructed to do so, especially if the medication has been given for an extended period.
Every brain is different, and much of how medications affect the brain is still unknown. Pharmacology should never be a one-size-fits-all approach. Medication needs to be personalized for the individual and carefully dialed in for optimum results.
It can take time and patience to find the right medication or combination of medications and requires persistence. Even if medications turn out to be ineffective, there are many other options for managing symptoms effectively.
What Other Treatments Are Available?
Despite the use of words like "treatment" and "symptom," autism spectrum disorders aren't diseases that need to be cured. Instead, they are differences in the neurological wiring of the brain, conditions that require management and adjustment. People with Asperger's who are given sufficient support and guidance can go on to lead extremely successful and happy lives. They just need the right environment and scaffolding to support them on their way.
The medication works best as one tool in an overall treatment plan that addresses social skills training, sensory integration, behavioral modification, and motor coordination. The best strategy is to take into account each's strengths and areas of difficulty and tailor a plan carefully to meet his or her needs.
Cognitive behavioral therapy (CBT) has been shown to be extremely effective for patients with Asperger's. A therapist can teach techniques for regulating and processing emotions, developing structure, and reducing obsessive thoughts. As most people with Asperger's tend to have difficulty understanding how to process social cues, a skilled therapist can teach techniques for relying on logic and reasoning to better interact socially. There is also occupational therapy and sensory integration therapy to help manage any potential areas of concern.
A therapist that specializes in ASD can help you better understand yourself and the way you think, as well as help you cope with any anxiety or depression you may be experiencing. BetterHelp can connect you with a therapist that will be able to guide you through the process of better controlling and managing your condition. Even if you're a parent of a child with Asperger's, you may find it beneficial to have support for yourself.
New information about autism spectrum disorders is being discovered all the time. The more you understand you or your child's condition and the available treatments, the more empowered you will feel in managing it appropriately.