General Information
When discussing medication for Autistic Spectrum Conditions such as ADHD
(Attention Deficit and Hyperactivity Disorder) it must be remembered that the
drugs do not treat the core disorder. Rather they assist with the symptoms
faced by the patient such as anxiety, agitation, and obsessive-compulsive types
of behaviour, and often moderate explosive tendencies. Unfortunately they
do not appear to assist with the core issues of the conditions.
Stimulant Medication
Many studies support the common belief among physicians that stimulants
provide the best treatment for Autistic Spectrum Conditions. The benefit
gained is most noticeably seen when dosage is small, however more significant
dosage can exasperate the symptoms and therefore see an increase in anxiety,
agitation, and obsessive-compulsive types of behaviour. This is however
awkward as dosage sizes are not available in such small amounts, leaving some
patients to be on as much as four to ten times the amount the should be on.
|
Safety
With the exception of Cylert, the drugs used by doctors for treating
ADHD are among the safest around.
Cylert (Magnesium Pemoline)
Known to cause liver damage. Normally avoided by doctors.
Methylphenidate (Ritalin & RitalinSR)
Ritalin has been on the market for over 30 years and has proven to be very
reliable. Unfortunately however it does not last more than 4 hours, and
many takes not more than 3 hours. RitalinSR was therefore produced and
marketed to last 8 hours, however often lasts less than 6 hours. The
benefit may also fluctuate throughout the day and from day to day. This
often causes a 'rebound' effect, in which their symptoms return and sometimes
more severely. This leads some doctors to question whether the overall
benefit is good or bad.
The Guardian newspaper release a report stating:
"Nine UK children have died after being prescribed Ritalin for Hyperactivity.
The safety of Ritalin, known as "the chemical cosh" is under review following
sudden deaths in the US. Ritalin and other drugs used to treat ADHD were
linked to the deaths of 51 Americans in one year. Dozens of others suffered
serious heart problems. It's prescribed for children as young as six. Some
US experts suggest that it should carry the highest health-warning"
|
|
|
We believe that anyone taking any form of medication should always consult a
doctor if they experience any medical symptoms, especially if they feel that
they are a side affect of prescribed drugs. Reactions to medications are
widely known for all types of medicines, and are normally unique to the
individual. This said the US and UK have medical oversight of all drugs
and when a pattern begins to form investigations are carried out. If you
are concerned about Ritalin and possible side affects do
not take your child off Ritalin, but rather consult medical advice from
your doctor.
MetadateIR, MetadateSR, MetadateER
The Metadate brand has three forms. The first 'IR' that lasts for
4 hours, the second SR which lasts for six to eight hours, and finally ER which
lasts twelve hours. The Metadate provides a stable reliable blood level
for the duration.
Concerta 18, 36 and 54mg
Concerta was first release in 2000. This differs from other methylphenidate
products in that it provides an initial release and a slow release mechanism.
The initial release medication is weaker than the slow release medication.
The helps reduce the 'rebound' effect seen with the use of other medications.
The mechanism also helps patients get to sleep more easily.
Dextroamphetamine S04 (Dexedrine Capsules 5, 10 & 15mg; Tablets 5mg)
The Dexedrine capsules last 12 hours due to the bead based design. The
different strengths of capsules contain different numbers of beads based on the
dosage. As such this allows for a manual, but careful, reduction of beads
allowing more easily for the correct dosage to be calculated for Autistic
Spectrum Conditions, such as Attention Deficit and Hyper Activity Disorder and
Asperger's Syndrome.
Mixed Amphetamine Salts (Adderall Tablets 5, 7.5, 10 15, 20 and 30mg)
Adderall XR is a twelve hour sustained-release form, and has begun use in the
USA. It's advantage over Dexedrine is that it is less likely to
cause a persistent feeling over overstimulation (e.g. described as 'a pressure
sensation', 'agitation' or 'edginess'). It is a little less likely to
suppress the appetite than Dexedrine, but i little more likely than
methylphenidate. It is also less likely to trigger the 'rebound' effect
seen with Dexedrine or Ritalin, however more likely to than Concerta.
Methamphetamine (Desoxyn Tablets 5mg)
This is also a twelve hour sustained-release base drug. The key
disadvantage of this drug is the extremely high cost, which has risen to the
point that few can afford it.
Strattera
In Feb 2006 the Daily Mail had an article on the potential dangers of Strattera,
following the suicide of 2 children and 200 others reporting serious side
affects of the drug which was only released in 2004. The MHRA report
released under the Freedom of Information Act also revealed that 20 children &
adults have killed themselves & 63 tried to commit suicide around the world.
We do not know of any further information at this time.
|
|
|
Anti-Anxiety Medications
These medications can be beneficial on an occasional basis, or if the patient
has a chronic, residual level of anxiety or agitation related to a co-existing
mood or personality disorder.
Benzodiazepines
- Xanax
This lasts for six to eight hours, and causes very little drowsiness.
It is therefore not a valuable sleeping aid unless the anxiety is the key
cause of lack of sleep.
- Klonopin
This a little more prone to cause drowsiness and therefore is a good
sleeping aid, lasting between eight and twelve hours.
- Ativan
This only works for four to six hours, however is prone to cause memory
problems (even in the oral form).
Sleeping Medications
Sleep disturbances are common with ADHD and Asperger's Syndrome, and persist
even when the symptoms are well controlled. This said most non-persistent
difficulties are found in the first few weeks of taking medication, and
therefore the following two drugs can be helpful.
|
Sonata (5 & 10mg)
This is especially useful for those who have trouble getting to sleep.
Sleep will occur within approx 20 to 30 minutes, however beneficially only last
2-3 hours. It therefore rarely leaves the 'hang over' feeling left by
other drugs. Additionally if the patient wakes during the night and has at
least three more hours of night remaining then another dosage can be taken.
This medication does not cause drowsiness like most sleeping medication, but
rather the patient must lie down and close their eyes, at which point sleep will
ensue. This said, if the patient waits until they are sleepy they can
bypass the period of effectiveness of the drug.
Ambien (5 & 10mg)
This medication lasts five to six hours, and again rarely leaves the patient
with a 'hangover' feeling in the morning. Additionally it does not build
up in the patients system, which in turn reduces the possibility of memory loss
and a sense of drowsiness during the day, experienced with many other drugs.
"Hybrid" Medications
This covers drugs which doctors prescribe however have not officially been
approved for the specific use of treatment of ADHD (this information may be
unique to the USA, or may have now changed).
Risperadal (1, 2 & 3mg)
This has proven beneficial in the treatment of Attention Deficit and
Hyperactivity Disorder andAS. Initial dosages for children are between
0.25 & 0.5mg (once then twice a day should be tried). Teenagers and Adults
may however require higher dosages. Gradual increase in dosage will allow
the avoidance of symptoms caused by too much medication. Initial use
causes drowsiness, and therefore recommended to initially be taken at bedtime.
Dosage is normally best taken evenly over the day in two equal amounts, however
may vary from patient to patient.
Other Drugs
Zyprexa, Neurontin, Carbatrol and Depakote have also been used by doctors.
We are unable to confirm what benefits are offered or issues relating to their
use.
Antidepressants
These drugs have been proven to assist with reducing anxiety and tendencies
towards obsessive compulsive disorders (OCD), often moderating patients
explosive tendencies and depression. As with all drugs recommended for
adults, this may be used for children as young as 12 years old. This said,
some doctors have used them on younger children, claiming beneficial results.
Zoloft (25, 50 & 100mg)
This appears to work best with anxiety and OCD symptoms. Initial usage is
best from half of a 25mg tablet (12.5mg) and then increasing in similar amounts,
if necessary. Increases are best made after three to four week intervals.
Faster increases can cause interfering side effects, as the patient adjusts to
the change in medication.
Other antidepressants, although function to some degree, are not apparently
as beneficial as Zoloft. It is recommended that the same procedure be
followed when using other antidepressants to maximise their benefits.
|
Over the Counter Medications
A number of medications available over the counter (under US regulations) are
claimed to provide similar benefits to the control drugs being subscribed.
These include:
- Caffeine
- Decongestants
- Nasal Decongestants (e.g. Afrin, NeoSynephrine, Otravin, Dristan)
- Phenylephrine HC1 (NeoSynephrine)
- Pseudophedrine HC1 (Sudaphed)
- Ephedrine (e.g. MiniThins)
- Ma Huang (aka Ephedra)
|
|
|
Our volunteer worker, Stephen, confirms that he has had definite benefit from
caffeine, 'Sudaphed' and decongestants. Those with ADHD often have
allergies which are often benefited by these medications, and in turn seem to
provide relief from anxiety and agitation etc. He does however point out
that Asthma can be negatively affected by caffeine, so should be avoided during
times when Asthma is not fully under control. He himself turns to Sudaphed
or a decongestant during these periods. This said, he confirms that
caffeine has been by far the most effective, however one needs to be careful not
to have too much and then stop immediately as this can cause the 'rebound'
effect. Stephen confirms that he finds Nescafe Gold Blend the most
effective, with the least negative effects. Please note that coffee can
cause the removal of vitamins and minerals from the body, particularly if large
quantities are drunk.
Additional Questions
If you have any further questions on these or other medications currently be
prescribed please let us know at
steve@adhdplus.support.
