The first time my husband and I considered trying medication to help Matthew was when he was ten years old. We didn’t like the idea of treating him with medication and were worried about side effects, but he was so consumed at the time with airplanes, and whether there was one flying overhead or not that there was nothing happening in school. We had tried everything-even a one-on-one teacher’s aide was not able to keep him focused.
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 year or two before children enter puberty is often the time when behavioral difficulties arise.” says Fred Volkmar, the director of the Yale Child Study Center. “We aren’t sure why this is, but changes in hormone levels are probably part of the picture.”
Our pediatrician referred us to a good child psychiatrist who prescribed Ritalin to help Matthew stay focused in school, and Luvox to help curb his obsessive-compulsive behavior.
After taking the Luvox for two weeks, Matthew’s airplane obsession evaporated, and his teacher noticed that he was more tuned in immediately after starting the Ritalin. The only side effect we noticed was mild sleep disturbance, but that went away after a few weeks.
When Matthew was in his late teens, he developed aggressive behavior and had daily emotional outbursts that were very scary. Visits from our local police were frequent, and after one particularly violent meltdown his school psychiatrist suggested we try Depakote, a mood stabilizer and another medication-Geodon-for aggression. These were some serious drugs and while they helped Matthew calm down in a big way, the side effects were unsettling. His hands were shaky and his personality had less sparkle. We fiddled with dosage and searched for medications with better side effect profiles, but never got it quite right.
Then last July, Matthew’s new psychiatrist in Santa Cruz suggested that we give Risperdal a try.
“A study in the American Journal of Psychiatry found that Risperdal not only decreased aggression in individuals on the spectrum, but also reduced repetitive behaviors and increased social interaction – all with limited side effects. I’m seeing great results with several of my patients on the spectrum.”
I was skeptical. I had two friends whose children had tried the drug, and while their behavior improved greatly, they gained weight. A lot of weight.
Dr. Lawrence Scahill, also at the Yale Child Study Center and the true expert on the Risperdal says that weight gain is a common side effect with drug.
“The mechanism appears to be directly related to appetite. So what a person eats is very important. Many families have discovered that it is best to keep high carbohydrate food junk food out of the house to avoid a daily struggle.”
We decided to give Risperdal a try, and almost right away, I thought we had found the miracle drug. Matthew was happier, more interactive and just plain easier to be with. The tremor went away, and Matthew seemed brighter and more curious.
He was also ravenous.
As I watched his weight was creeping up, I told myself that it was better for him to be happy and more interactive than skinny and miserable.
But since he started Risperdal in July, he’s gained over 20 pounds. He is still ravenous and craves the kind of food that will cause him to gain even more.
So it is time for a little troubleshooting.
I’m meeting this week with Matthew’s psychiatrist and with the folks at Camphill, where Matthew lives, to come up with a strategy.
Juggling the benefits and the side effects of medication for the behaviors associated with autism can be unnerving for parents, but as John Forrest, the father of a 15 year old daughter with the disorder says, “If my daughter is happier and more interactive with medication, I can forgive a side effect or two.”
To be continued:
To learn more about medication and autism, follow this link.
CALENDAR OF UPCOMING EVENTS:
Marin Autism Lecture Series
Tuesday, January 12, 2009
San Carlos Children’s Theater Offers Theater Based Social Skills Play Group
Sonoma Walk Now for Autism Speaks 2010
Want to read the first three chapters of A REGULAR GUY: GROWING UP WITH AUTISM?