Autism Spectrum Disorder Management: Medication Treatment and Potential Drugs

Before starting pharmacotherapy in children with an autism spectrum disorder (ASD), there is a lot of consideration. There is a consensus that a comprehensive pretreatment evaluation should be administered. Medication can only be warranted if the child’s behaviour interferes with their ability to access therapy and comorbidities and other external stressors have been encountered. Every child with autism spectrum disorder should be assessed on a case by case basis. Medical practitioners should also collect medical history from various sources, including patients, parents, therapists and special needs educators, to identify the most appropriate target behaviour. Hence, specialists familiar with autism spectrum disorder will prescribe the proper medication for patients after a careful and comprehensive assessment.

When choosing a drug:

• Likelihood of improvement in the target symptom
• Potential side effects
• Available formulations
• Dosing schedule
• Cost
• Requirement for laboratory monitoring

Here is a list of the current medications approved by the FDA for autism spectrum disorders:

	Risperidone	Aripiprazole
Mechanism	Involve a reduction of dopaminergic neurotransmission in the mesolimbic pathway	Partial agonist at the D2 and 5-HT1A receptors and an antagonist at the 5-HT2A receptor, lowering dopaminergic neurotransmission in the mesolimbic path.
Indication	Children from 5-18 years old with autism are associated with irritability, including aggression, temper, tantrums, self-injurious behaviour, and quickly changing moods.	6-17 years old children with associated irritability( including aggression, deliberate self-injurious behaviour, temper tantrums, and quickly changing moods).
Possible Side Effects	1. Activating effects (e.g., akathisia, restlessness)  2. Sedating effects (e.g., sedated state, drowsiness) 3. Angioedema 4. Dyslipidemia 5. Extrapyramidal SymptomsDysphagiaOesophageal dysmotilityAspiration 6. Hematologic abnormalitiesLeukopeniaNeutropenia, ThrombocytopeniaAgranulocytosis 7. Neuroleptic malignant syndrome 8. Orthostatic hypotension 9. Sexual dysfunction 10. Temperature dysregulation 11. Weight gain	1. Weight gain 2. Akathisia, headache 3. Orthostatic hypotension, tachycardia 4. Hyperglycemia 5. Abdominal distress, constipation 6. Neutropenia 7. Arthralgia 8. Nasal congestion

Currently, scientists are researching various drugs that can be used to address the symptoms of autism spectrum disorders in the future.

Here is the list of potential drugs and their possible benefits:

1. Methylphenidate: To improve symptoms of hyperactivity and inattention in children with ASD.
2. Guanfacine, clonidine: To improve inattention, hyperactivity, and impulsivity symptoms in children with ASD.
3. Atomoxetine: To improve symptoms of hyperactivity and inattention in children with ASD.
4. Olanzapine, clozapine, quetiapine, ziprasidone, haloperidol: To treat irritability and self-injurious and aggressive behaviour in children with ASD.
5. Fluoxetine: To treat repetitive behaviour in children with ASD.
6. Fluvoxamine: To reduce repetitive behaviours and has better effects in adults with ASD.
7. Sertraline: To improve repetitive and disruptive behaviour.
8. Paroxetine: To reduce aggression.
9. Melatonin: For sleep disturbance.

To sum up

It is essential to know that every child with ASD needs to be carefully assessed. After a comprehensive evaluation conducted by specialists, they will be given the best course of treatment, according to their specific condition and  response to different medications. Medical practitioners should continuously monitor and examine their target symptoms to adjust the type and doses of drugs. There is still a rising need to research other drugs to encounter target symptoms such as aggressiveness, restlessness and impulsivity.

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