Question about meds in a 6 yr old boy with autism, ?

Question

ADHD, tardive dyskensia, hyptonia and a sleep disorder. Johnny is currently on Trazadone, Wellbutrin and Clonodine and has tried several different other medications for the most recent was Metadate. Nothing seems to working to control his outburts. He was diagnosed when he was 2 years old and had a good set of meds then. He was on Risperdal and after two years of being on the drug he developed tardive dyskensia from it and can no longer take it anymore and now ever since then things have not been going well at all.

This is not my child, and I'm curious about several things. What doctor would prescribe risperdal to a 4 yr old (or younger) in such doses that serious side effects like tardive dyskensia would develop. Wouldn't behavioral intervention be first course, not meds? Something smells fishy to me and I'm curious as to what others think. Thanks.

Answer 1

many docs prefer to wait until a child is 5 to start meds-

meds for tghings like OCD, ADHD tned to make children with autism worse-

it is very difficult to deternine if a child with autism also has soemthign liek ADHD-often it is sensory intergration disorder--not ADHD-...they both produce teh same behaviors-

I would suggest an intense sensory diet prescribed by an occupational theapist--

and an evaluation by an actual autism center-(not a basic developmental doc) to determine if there are realy so many coexisting conditions-especially tehy ADHD

Answer 2

There was a time that I was very skeptical of meds in kids, but I have a couple of good friends with severe ADHD who tooks meds as kids. They're in their forties now, one is creative director of a successful video game company, and the other is a Lieutenant Colonel in the army.

I've also had to become familiar with the files of kids taking meds in school, and seen a wide variety of experiences there. Sometimes the meds work so well, the kids' teachers are surprised to find out they have ADHD. And there are kids whose parents are dead-set against meds. Everybody in the school building and half the community realize the kid has some kind of disability, whether or not they know the diagnosis. Many experiences in between, of course.

I don't have as much experience with tiny kids on meds, but I'm surprised by what I read about early, early diagnosis of conditions like bipolar disorder. Now we know how important early interventions is, of course.

The second act in the radio show I've linked below--about 24 minutes in--was an ear-opener to me.

  

Answer 3

Hi Kathi,

Yes, risperdal would be first line of tx for a kid that has so much going on.  Behavioral intervention is beneficial but for kids that are so affected it is usually in conjunction with meds.  Risperdal is FDA approved for autism, but many docs use off-label meds too.  I don't know about the tardive symptoms, I have never seen TD in kids, I do know that adults are usually prescribed cogentin as a tardive-protective med.  What is the dose of Risperdal that was used, and how much about does the kids weigh?  Has the kid been to a GI doc or allergist?  How about a GF/CF diet?  What kind of sleep disorder, I have not seen Trazodone (deseryl) used in kids, usually its benadryl.

The Metadate, I REALLY don't like stimulants for the autistic population.  I run into so many that have tried like 5 different stimulants.  My father who is a psychologist (and asperger's) is a clinician for AdvoServ which is a residential autistic setting and he claims that all day long he takes kids off stimulants and puts them on risperdal and xanex and to stay away from stimulants and to stay away from anti-depressants.  The wellbutrin is an atypical antidepressant. Metadate not only does it cause impulsivity also it tends to cause psychotic symptoms.  First line of tx for autism in our area with ADHD is risperdal and xanex.  Xanex hasn't been tried? 0.25mg of xanex goes a long way.  Clonidine usually works well for these kids too.  I don't find it particularly fishy.  Neither of my sons are medicated.  Medication is great when needed and mine are holding on ok without so far, but we do give 0.25mg of xanex before the dentist for my oldest who is 7.9 yrs.

Two is extreme, but I have seen cases where I definately felt it was necessary.  It is hard without knowing him.  One kid that comes to mind was 3, just turned 3 even, still in a diaper and had put the cat in the dryer killing it, and also stabbed his brother with kitchen scissors requiring an infant to need 20 some odd stitches, and what finally brought him to the hospital was his mother waking in the middle of the night with the 3 yr old standing beside the bed with a large kitchen knife in his hand chanting kill, kill, kill

EDIT I totally agree with 'just me' about kids with autism having symptoms that mimic ADHD and are really sensory integration issues.