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Suggest Treatment For Autism In Children
Question: I need to talk to a pschiatrist about medication for my autistic son. We are desperate
Looking for medication answers for a 13 yr old autistic boy
Looking for medication answers for a 13 yr old autistic boy
Brief Answer:
Kindly give details of his problems and medications used.
Detailed Answer:
Hello
Welcome to HCM.
Thanks for choosing this platform for asking your health related queries.
You want to discuss about medications of your son who is suffering from autism.
Usually, the drug treatment of a child with autism depends on his behavior problems.
Kindly give details of his behavior problems and the medications which you have been trying for him.
I am Dr. Shubham Mehta, MD(Psychiatrist). I will try to help you in all the possible ways here.
Hope to hear from you soon.
Regards.
Kindly give details of his problems and medications used.
Detailed Answer:
Hello
Welcome to HCM.
Thanks for choosing this platform for asking your health related queries.
You want to discuss about medications of your son who is suffering from autism.
Usually, the drug treatment of a child with autism depends on his behavior problems.
Kindly give details of his behavior problems and the medications which you have been trying for him.
I am Dr. Shubham Mehta, MD(Psychiatrist). I will try to help you in all the possible ways here.
Hope to hear from you soon.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He is taking invega because risperidone caused "tics" and has been on it for close to a year. 9 mg per day. Also for over a year he has been on clonidine .1 mg 4x per day. For about ths same time, divalproex 500 mg 4x a day. He was doing ok and recently started being very hyperactive. We were told to wean off clonidine and start ituniv because psychiatrist thought to many ups and downs on clonidine. After 2 weeks (almost a month ago) he became very aggresive so we went back on clonidine. We also increased his divalproex to 1000 mg and started blood tests to get serum levels. He became very aggressive. We lowered it back to 125 mg 4x per day. My question is after giving him his doses of clonidine and divalproex (.1 and 125) he gets very aggressive and dangerous almost 45-60 min later. In the morning he retches like he is going to vomit. Can clonidine or clonidine start doing this after over a year of working well
?
?
Brief Answer:
Unusual for clonidine to cause aggression.
Detailed Answer:
Thanks for the details.
I have gone through these thoroughly.
Invega(paliperidone) is active metabolite of risperidone. In my clinical experience, the efficacy of invega is much less than risperidone. But as your child developed tics with risperidone, I think olanzapine can be a better substitute to control aggression.
Coming to your question, it unusual that person becomes aggressive with clonidine after well for long time.
I think he has had comorbid ADHD (you mentioned he also has autism) which might have been missed by his treating doctor.
This under-treated ADHD is probably being manifested as aggression and hyperactivity now.
Though clonidine and Ituniv is used in treatment of ADHD, I would suggest that he should be started with a medication like atomoxetine (prescription drug). This drug is far better in controlling hyperactivity.
So, my treatment plan for him would be:
1. Invega (if it suits him) or olanzapine.
2. start with atomoxetine, consider tapering down clonidine.
3. continue with divalproex.
Kindly discuss these issues with your doctor.
Hope this helps.
Thanks.
Unusual for clonidine to cause aggression.
Detailed Answer:
Thanks for the details.
I have gone through these thoroughly.
Invega(paliperidone) is active metabolite of risperidone. In my clinical experience, the efficacy of invega is much less than risperidone. But as your child developed tics with risperidone, I think olanzapine can be a better substitute to control aggression.
Coming to your question, it unusual that person becomes aggressive with clonidine after well for long time.
I think he has had comorbid ADHD (you mentioned he also has autism) which might have been missed by his treating doctor.
This under-treated ADHD is probably being manifested as aggression and hyperactivity now.
Though clonidine and Ituniv is used in treatment of ADHD, I would suggest that he should be started with a medication like atomoxetine (prescription drug). This drug is far better in controlling hyperactivity.
So, my treatment plan for him would be:
1. Invega (if it suits him) or olanzapine.
2. start with atomoxetine, consider tapering down clonidine.
3. continue with divalproex.
Kindly discuss these issues with your doctor.
Hope this helps.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the info. Risperidone did work very well you are right. I'm with you regarding the clonidine but for some reason 45-60 minutes after taking it he gets very aggressive and violent. Perhaps it's just because he is so unstable right now any change in how he feels throws him off "balance".
We did try atomexetine. It, like all the other meds we tried never worked and most of the time if it did work it was the side affects (drowsiness) that calm him and once they wore off a couple of weeks later he went off the rails again.
I should clarify that it he is on 500 mg daily divided into 4 doses. We are waiting for his blood tests to come in to see where his serum levels are.
Few last questions: is it likely only 500 mg of divalproex per day can work or is it likely there could be negative side affects at that dose?
Wasn't really a tic from risperidone but our Dr felt we should try something different in case it was. My wife and I said risperidone always worked the best. His appetite goes through the roof on olanzapine. What dose equals 9 mg of Invega? About 4.5 I estimate.
We've tried every med class you can think of from stimulants, ssris, old and new antipsychotics, mood stabilizers, etc etc. We see our psychiatrist in a couple of weeks and he has been mentioning naltrexone which I know is Narcan. Could I get your opinion on that?
We did try atomexetine. It, like all the other meds we tried never worked and most of the time if it did work it was the side affects (drowsiness) that calm him and once they wore off a couple of weeks later he went off the rails again.
I should clarify that it he is on 500 mg daily divided into 4 doses. We are waiting for his blood tests to come in to see where his serum levels are.
Few last questions: is it likely only 500 mg of divalproex per day can work or is it likely there could be negative side affects at that dose?
Wasn't really a tic from risperidone but our Dr felt we should try something different in case it was. My wife and I said risperidone always worked the best. His appetite goes through the roof on olanzapine. What dose equals 9 mg of Invega? About 4.5 I estimate.
We've tried every med class you can think of from stimulants, ssris, old and new antipsychotics, mood stabilizers, etc etc. We see our psychiatrist in a couple of weeks and he has been mentioning naltrexone which I know is Narcan. Could I get your opinion on that?
Brief Answer:
Should try naltrexone.
Detailed Answer:
Hi again.
sorry for the late response.
yes, invega 9mg would roughly be equal to 4.5 mg of risperidone.
If he was doing good on risperidone, I would recommend that you should restart with it.
The dose of divalproex is 20-25mg per kg of body weight. I do not think 500mg would be sufficient to control his anger. The side effects would be visible however, at this dose.
Naltrexone has been suggested for use in ADHD but is still under investigation.
When no other drug has worked for him, I think there is no harm trying naltrexone as well.
Hope this is of some help for you.
Take care.
Regards.
Should try naltrexone.
Detailed Answer:
Hi again.
sorry for the late response.
yes, invega 9mg would roughly be equal to 4.5 mg of risperidone.
If he was doing good on risperidone, I would recommend that you should restart with it.
The dose of divalproex is 20-25mg per kg of body weight. I do not think 500mg would be sufficient to control his anger. The side effects would be visible however, at this dose.
Naltrexone has been suggested for use in ADHD but is still under investigation.
When no other drug has worked for him, I think there is no harm trying naltrexone as well.
Hope this is of some help for you.
Take care.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You are very helpful. Best $45 ive spent! Could you provide your opinion and comments as to why almost to the minute, 50 minutes of giving him his clonidine dose does he go completely beserk? Why after 3 years did this start? It wasnt like an on off switch but seemed to start about 3 months ago and was one of the reasons we tried intuniv. He has never recovered from that change. Thanks again, you really helped.
Brief Answer:
No appropriate explanation for aggression after clonidine.
Detailed Answer:
Hi again.
Sorry that I kept you waiting for my response.
I am not sure about the reason for anger outbursts after 45-50minutes of clonidine.
I have even searched the literature for this but could not find appropriate explanation for this.
Though clonidine is indicated for hyperactivity and aggression in autism and ADHD, agitation and irritability are also listed as its side effects.
This may be one of the rare cases in which clonidine is causing agitation.
A drug change back to risperidone might help in this.
I have found some literature about utility of gingko biloba (herbal remedy) in such cases. You can discuss this with your treating doctor if he is willing to try this.
Wishing for speedy recovery of your child.
You are most welcome if you have more queries in future.
Hoping for a positive feedback from you.
Regards.
Dr. Shubham Mehta, MD
No appropriate explanation for aggression after clonidine.
Detailed Answer:
Hi again.
Sorry that I kept you waiting for my response.
I am not sure about the reason for anger outbursts after 45-50minutes of clonidine.
I have even searched the literature for this but could not find appropriate explanation for this.
Though clonidine is indicated for hyperactivity and aggression in autism and ADHD, agitation and irritability are also listed as its side effects.
This may be one of the rare cases in which clonidine is causing agitation.
A drug change back to risperidone might help in this.
I have found some literature about utility of gingko biloba (herbal remedy) in such cases. You can discuss this with your treating doctor if he is willing to try this.
Wishing for speedy recovery of your child.
You are most welcome if you have more queries in future.
Hoping for a positive feedback from you.
Regards.
Dr. Shubham Mehta, MD
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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