Autism Medicines: Intuniv, Concerta, Vyvanse, Risperidone, and Clonidine
It is hard to make the choice to put your child on daily medicines. Although I often feel guilty about putting my son on medication, I can see no other alternative.
I tried the gluten-free diet as well as other diets; I eliminated foods containing red dye; and I limited his sugar intake. For his sleep problems, I tried melatonin, bedtime rituals, and back rubs. However, none of these natural remedies worked, and I was at my wit's end.
The summer before my son entered kindergarten, it became apparent that in order to succeed in a regular school setting he would need medication. In daycare he was unable to sit still and couldn't focus on tasks unless he was doing an activity he liked, such as playing with cars or blocks.
The doctor recommended that we start him on the lowest dose of the blood pressure medicine Intuniv. In clinical trials, many autistic children showed improvement in attentiveness. After a few weeks on the Intuniv, my son did show a little improvement in his ability to focus.
He started kindergarten in a mainstream classroom a few months later, and immediately the teacher had problems getting my son to focus. After repeated attempts by the teacher to get my son to participate in activities, he would have a meltdown and I would be summoned to school to get him. North Carolina does put much emphasis on funding its schools, and the poor teacher had no assistance from qualified special-ed teachers. She had her hands full with the other 24 children in the classroom.
After another call to the doctor, the Intuniv dose was increased, but it had little effect. Three months into the school year, the Intuniv was stopped and my son was prescribed Concerta, a stimulant used for ADHD. The change in my son was dramatic—he became very quiet and was able to focus and sit still for long periods of time. It did make me sad to see him so solemn and quiet, but it was also a relief to have a break from the boy who could not sit still unless he was stimming with his toys.
Concerta Side Effects
Concerta did have two unwanted side effects: appetite loss and throat clearing. My son was born skinny and has stayed skinny. He would eat first thing in the morning, but after the Concerta took effect, he would not be interested in eating until the evening. He initially lost a pound or two, but by letting him eat whenever he wanted, he stabilized and lost no more weight - but he also never gained any in the year he was on Concerta.
The throat clearing started within a month of starting the Concerta. I hoped it was temporary, but it continued the entire time he was on the medication.
No Help for His Anger
The Concerta had no effect on his anger or meltdowns. He was always prone to self-destructive behavior such as head-banging and slapping himself, and he frequently went into rages at home over minor annoyances. Toys were thrown, stomped on and otherwise destroyed. Furniture in his room was marred and tipped over. If he ran into a wall he would rage at the "stupid wall" that was trying to hurt him.
Although my son could now sit still at school, he ultimately failed kindergarten.
Vyvanse, Clonidine, and Risperidone
The following medicines were the more recent—and more successful—medicines prescribed for my son.
He was put on the ADHD medicine Vyvanse, another stimulant used for treating the ADHD that so often occurs with autism. The Vyvanse replaced the Concerta, which had caused my son to constantly clear his throat, an unwanted side effect.
Vyvanse, I Love You!
The Vyvanse works well for my son's ADHD. He is now able to focus at school and is no longer constantly bouncing off the walls during the day.
Ironically, before he was on a stimulant medicine, he would not leave my side. It is one thing to have a hyper child; it is another to have a hyper child who is constantly hanging and pulling on you and won't go outside to work off some of his energy.
Just like Concerta, Vyvanse had no effect on my son's rages.
An unwanted side effect is appetite suppression. At 8 years old and 46 inches tall, my son weighed 39 pounds. He will not be hungry for most of the day but will eat in the evening when the medication wears off.
Clonidine for his Sleep Problems, Hallelujah!
My son has had difficulty sleeping since he was about two. He did not want to go to sleep and would lie in his bed for hours. It drove me to tears many times because at the time I was in college and needed to do homework and be rested for my hospital clinicals. To make matters worse, he never slept late in the morning.
He was also plagued by nightmares. He awoke every single night screaming, "Mommy, Mommy, Mommy!" He couldn't tell me what his nightmares were about, but he would go back to sleep as long as I was near him. I started to let him sleep in my bed so I wouldn't be so exhausted in the morning.
My son and I moved to North Dakota when he was seven. He was referred to a psychiatrist because of the sleeping and anger issues. The doctor prescribed clonidine as a sleeping aid. Clonidine's primary use is as a blood pressure medicine, but it is also prescribed for ADHD and insomnia.
The night of the first dose I was skeptical that he would go to sleep. But within 45 minutes of taking the medicine he said he was tired and wanted to go to bed. I was almost delirious with relief. At long last I had a few hours of quiet time in the evenings.
Risperidone (brand name Risperdal) for anger!
I thought that my son's anger would subside once he started to get more rest, but the extra sleep didn't help at all and he still awoke at night because of nightmares.
The psychiatrist and I discussed risperidone, an antipsychotic drug. Risperidone's main use is for the treatment of schizophrenia and bipolar disorder, but it is also used to treat anger and aggression in autistic children.
The risperidone has worked very well. My son is no longer as angry and violent when he gets upset. He still has a temper, but the uncontrollable rages are gone! He also plays much better with other children and he very rarely wakes up in the middle of the night.
An unwanted side affect of risperidone is weight gain and gynemastia (man boobs). No signs of any breast growth, but he no longer looks like a famine victim and is now at a healthy, but still slender, weight.
My feelings about medicating my son
I used to be one of those people who felt drugs are being overprescribed to children. I was smug and thought my parenting technique was all that was needed to raise happy, healthy children. It may have worked for my two older kids, but I got the smug kicked right out of me.
I do not like medicating my son, but I know that without the medicines, life would be awful—for both my son and me. We are now both so much happier, relaxed, and loving. I hope some day my son can stop taking these medicines, and from what I have read, that may be likely as he matures.
Life is good.