Autism Treatments - Dietary And Medical ASD
Treatments
In an effort to do everything possible to help their
children, many parents continually seek new treatments. Some
treatments are developed by reputable therapists or by parents of a
child with ASD. Although an unproven treatment may help one child,
it may not prove beneficial to another. To be accepted as a proven
treatment, the treatment should undergo clinical trials, preferably
randomized, double-blind trials, that would allow for a comparison
between treatment and no treatment. Following are some of the
interventions that have been reported to have been helpful to some
children but whose efficacy or safety has not been proven.
Dietary Treatments
Dietary interventions are based on the idea that 1)
food allergies cause symptoms of autism, and 2) an insufficiency of
a specific vitamin or mineral may cause some autistic symptoms. If
parents decide to try for a given period of time a special diet,
they should be sure that the child's nutritional status is measured
carefully.
A diet that some parents have found was helpful to
their autistic child is a gluten-free, casein-free diet. Gluten is a
casein-like substance that is found in the seeds of various cereal
plants—wheat, oat, rye, and barley. Casein is the principal protein
in milk. Since gluten and milk are found in many of the foods we
eat, following a gluten-free, casein-free diet is difficult.
A supplement that some parents feel is beneficial for an autistic
child is Vitamin B6, taken with magnesium (which makes the vitamin
effective). The result of research studies is mixed; some children
respond positively, some negatively, some not at all or very little.
In the search for treatment for autism, there has been discussion in
the last few years about the use of secretin, a substance approved
by the Food and Drug Administration (FDA) for a single dose normally
given to aid in diagnosis of a gastrointestinal problem. Anecdotal
reports have shown improvement in autism symptoms, including sleep
patterns, eye contact, language skills, and alertness. Several
clinical trials conducted in the last few years have found no
significant improvements in symptoms between patients who received
secretin and those who received a placebo.
Medications Used in Treatment
Medications are often used to treat behavioral
problems, such as aggression, self-injurious behavior, and severe
tantrums, that keep the person with ASD from functioning more
effectively at home or school. The medications used are those that
have been developed 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 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.
A child with ASD may not respond in the same way to medications as
typically developing children. It is important that parents work
with a doctor who has experience with children with autism. A child
should be monitored closely while taking a medication. The doctor
will prescribe the lowest dose possible to be effective. Ask the
doctor about any side effects the medication may have and keep a
record of how your child responds to the medication. It will be
helpful to read the "patient insert" that comes with your child's
medication. Some people keep the patient inserts in a small notebook
to be used as a reference. This is most useful when several
medications are prescribed.
Anxiety And Depression
The selective serotonin reuptake inhibitors (SSRI's)
are the medications most often prescribed for symptoms of anxiety,
depression, and/or obsessive-compulsive disorder (OCD). Only one of
the SSRI's, fluoxetine, (Prozac®) has been approved by the FDA for
both OCD and depression in children age 7 and older. Three that have
been approved for OCD are fluvoxamine (Luvox®), age 8 and older;
sertraline (Zoloft®), age 6 and older; and clomipramine (Anafranil®),
age 10 and older. Treatment with these medications can be associated
with decreased frequency of repetitive, ritualistic behavior and
improvements in eye contact and social contacts. The FDA is studying
and analyzing data to better understand how to use the SSRI's
safely, effectively, and at the lowest dose possible.
Behavioral Problems
Antipsychotic medications have been used to treat
severe behavioral problems. These medications work by reducing the
activity in the brain of the neurotransmitter dopamine. Among the
older, typical antipsychotics, such as haloperidol (Haldol®),
thioridazine, fluphenazine, and chlorpromazine, haloperidol was
found in more than one study to be more effective than a placebo in
treating serious behavioral problems. However, haloperidol,
while helpful for reducing symptoms of aggression, can also have
adverse side effects, such as sedation, muscle stiffness, and
abnormal movements.
Placebo-controlled studies of the newer "atypical" antipsychotics
are being conducted on children with autism. The first such study,
conducted by the NIMH-supported Research Units on Pediatric
Psychopharmacology (RUPP) Autism Network, was on risperidone (Risperdal®).
Results of the 8-week study were reported in 2002 and showed that
risperidone was effective and well tolerated for the treatment of
severe behavioral problems in children with autism. The most common
side effects were increased appetite, weight gain and sedation.
Further long-term studies are needed to determine any long-term side
effects. 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.
Seizures
Seizures are found in one in four persons with ASD, most
often in those who have low IQ or are mute. They are treated with
one or more of the anticonvulsants. These include such medications
as carbamazepine (Tegretol®), lamotrigine (Lamictal®), topiramate (Topamax®),
and valproic acid (Depakote®). The level of the medication in the
blood should be monitored carefully and adjusted so that the least
amount possible is used to be effective. Although medication usually
reduces the number of seizures, it cannot always eliminate them.
Inattention And Hyperactivity
Stimulant medications such as
methylphenidate (Ritalin®), used safely and effectively in persons
with attention deficit hyperactivity disorder, have also been
prescribed for children with autism. These medications may decrease
impulsivity and hyperactivity in some children, especially those
higher functioning children.
Several other medications have been used to treat ASD symptoms;
among them are other antidepressants, naltrexone, lithium, and some
of the benzodiazepines such as diazepam (Valium®) and lorazepam (Ativan®).
The safety and efficacy of these medications in children with autism
has not been proven. Since people may respond differently to
different medications, your child's unique history and behavior will
help your doctor decide which medication might be most beneficial.
Recent studies have shown that there is
currently a worldwide autism epidemic. In fact, more than 1.5
million people are affected in the United States alone, with one in
every 250 children diagnosed.
It's true that early detection and early treatment are the two key
factors in improving prognosis -- but too often parents get bogged
down in denial or confusion about this still mysterious disorder,
and are unable or unwilling to take the necessary steps.
The Essential Guide to Autism contains advice and information that
will help you make the right treatment decisions for your child.
Today, many youngsters can be helped to attend school alongside
their peers. Some programs are demonstrating that with appropriate
support, many people with autism can be trained to do meaningful
work and participate fully in community life.
All of the materials on this site have been included for the purpose of
providing general information, and they should not be relied on as a
substitution for professional advice.
