Many parents of autistic children face the dilemma of whether to place their kids on drugs in order to modify behaviors that interfere with their safety and/or learning. Some of these drugs are are approved for children with autism, and some are prescribed “off label.” That is, the treating physician (in our case, psychiatrist) feels that the drug may help them, but it is not approved specifically for autism. It might be approved for ADHD or depression, but not autism (e.g., Ritalin). http://psychcentral.com/lib/2010/medications-for-autism/.

At the time that our children were being prescribed drugs for the purpose of improving their functioning (and the ability of other people to tolerate them), there  were very few “on label” drugs for children or adults with autism.

Our doctor’s motto seemed to be “trial and error.” Sometimes I would get the feeling that my kids were lab mice.

First it was Ritalin for both Will and Mary. Try the least harmful and most studied in children first. Then Mary’s teachers called me in a panic to tell me that with the Ritalin, Mary had even less language and was very tearful. No more drugs for her, I said. One of her therapists said that sometimes Ritalin had the effect of increasing autistic features, which could be diagnostic for kids with autism.

Ritalin didn’t help Will at all, so we were on to Wellbutrin for both Will and Patty.

Patty would put the pill in her mouth, then spit it out later. She said it made her feel funny. Smart girl.

Wellbutrin caused Will’s heart to beat too fast, so he was put on Effexor, which I gave him for years, because it seemed to be effective. When Will had the flu in 1995, he developed a secondary infection of bronchitis and our pediatrician put him on an antibiotic, which in combination with the Effexor, affected his liver. Then the psychiatrist told us to always get a flu shot for Will, since the Effexor was necessary…..due to Will’s autism.

Whenever Will experienced more symptoms of aggression, meltdowns, etc., we adjusted his drugs or tried something else. But when the doctor suggested that we try Risperdol, I struggled. Risperdol had been suggested for me (I have bipolar disorder) and I had already read the side effects and decided not to put it in my body. One of the side effects is Tardive dyskinesia…the development of ticks and involuntary movements which may not be reversible. I worked in a nursing home when I was going to college, and I know what Tardive dyskinesia looks like. That is all Will needed, I thought…something to make him more of a spectacle…something that might not be able to be reversed. After some soul searching and tears, I REFUSED to give him any more drugs, especially that one. The behaviors we were concerned with would have be dealt with some other, mechanical way. That is, through talking, charts, quiet rooms, etc.

Now I see that Risperdol has been approved for treatment of autistic behaviors. I have very mixed feelings about this. However, parents and doctors need to weigh the risks and benefits very carefully. I am not against drug therapy for autistic kids.  Effexor did help for a while, although we eventually chose to end Will’s drug therapy. I still take a drug for my own bipolar disorder because the risk of untreated bipolar disorder for me is greater than the risk of taking my medicine.