Sunday, February 10, 2013

Autism and Medications

After the tragic killings in December at Sandy Hook Elementary School, the media speculated upon the possibility that shooter Adam Lanza had an autism spectrum disorder as well as reporting what medications he might have been taking. While the autism community quickly reacted by issuing statements adamantly denying a link between autism and planned violence, some discussion arose linking medications to violent behavior. Some parents who strongly oppose medicating their children with autism circulated information that cited several instances where school shooters had been taking psychiatric medications. A writer and autism mom whom I respect and admire, Teresa Conrick, posted an article on the Age of Autism website entitled “Pharmagunddon: School Shooters and Psych Meds” detailing various instances in which school shooters were allegedly taking psychiatric medications at the time they committed their heinous crimes. [To read this article, click here.] While I appreciate the thoroughness of her research and her invitation for the reader to “be the judge,” I have trouble agreeing with the implication that the medication caused the violent behaviors.

In a college course dealing with statistics, I learned the adage, “Correlation does not imply causation.” While these individuals may have been taking psychiatric medications, the behaviors that led doctors to prescribe these drugs more likely impacted the individuals to a greater extent than the medications themselves. Perhaps the medications they were taking were not the best for treating their conditions, or they may have needed different dosages than they were taking at the time.  In addition, some medications such as SSRI’s must be taken for a few weeks before symptoms improve, which could be a factor. Moreover, they may not have been compliant about taking the medications as directed, rendering them useless.  Too many variables exist to make judgments as to whether these drugs made people more susceptible to engaging in violent behavior.

Although I understand parents’ reluctance to put their children on medication, in some cases medication may be necessary for the well being of the children. If a child has diabetes and needs insulin, the parents would be negligent not to make certain the child received that medication.  In autism, co-morbid conditions, such as obsessive-compulsive disorder or anxiety, may benefit from medications that help the brain and the rest of the nervous system function better.  While I understand that some parents prefer to try vitamins, supplements, and other less drastic interventions, sometimes more is needed to address problem behaviors. I’ve noticed that some of the most vocal parent critics are those whose children are still young; until the child has gone through adolescent hormonal changes that can greatly impact behavior, from our experience, I would advise waiting to rule out medications completely.

From the time Alex was diagnosed with autism at four years of age, we began using biomedical treatments to help improve his various neurological issues. He became quite adept at swallowing pills at an early age, and he took as many as four dozen supplement pills each day, under the direction of our family doctor who specialized in nutrition. From vitamins to minerals to amino acids to essential fatty acids, Alex took whatever he needed to make his body work better. In addition, we put him on a strict gluten-free and casein-free diet that he maintains even today to address his food sensitivities and allergies. We treated him for yeast overgrowth in his digestive system, and we did chelation therapy to rid his body of toxins that had accumulated. Whatever interventions he needed, we pursued in hopes of making him as healthy as he could be, and we hoped to avoid putting him on medications. However, when his OCD behaviors became quite upsetting to him at age eleven, his doctor felt he would benefit from taking the SSRI Prozac. The improvements in his anxiety and behavior, such as frantically checking clocks to see what time it was and slamming doors in a ritual before bath time, came as a great relief to him and to us. Clearly, he needed his serotonin levels regulated in order to function better and stay calm.

Last year, when we had to hospitalize him in the behavioral medicine department for severe anxiety and aggression, his psychiatric nurse practitioner believed that after nine years, Prozac no longer worked for Alex. During his hospital stay, she tried a variety of medications at various doses until finally reaching a combination that kept him calm and prevented him from the dangerous aggressive meltdowns we had been facing for months. Currently, he takes the SSRI Zoloft along with mood stabilizers, an anti-psychotic drug, and sedatives. While we must monitor his behavior and watch for side effects as well as have regular blood tests to check his levels, we are pleased with the significant improvements we have seen while he has been on these medications.  (Fortunately, he is not taking any of  “The Top Ten Legal Drugs Linked to Violence” listed in Teresa Conrick’s article.)

Do we worry about the long-term effects of these medicines on his system? Certainly! Would we prefer that he not have to be on medications and deal with some mild side effects? Absolutely! Are we hopeful that he will eventually be able to wean off these medications and go back to taking supplements instead? Of course! However, at this point with Alex’s current issues, medication has taken away the behaviors that made him a danger to others and allowed the three of us to live peacefully.  Until God heals Alex—and I know He can—we are thankful for the expertise of Alex's psychiatric nurse practitioner and for the medications that help him overcome extreme anxiety so that he can be his happy, docile self.

“But for you who fear my name, the Sun of Righteousness will rise with healing in his wings. And you will go free, leaping with joy like calves let out to pasture.” Malachi 4:2


Anonymous said...

Thank you.

Anonymous said...

I agree"Thank You." If I have not learnt anything else I have learn that treatmenr of Autism is a different path for everyone. Linda

Pam Byrne said...

Thanks to both of you for your comments. I hope that the information I share in the blog might be helpful to other families dealing with autism and to those who want to learn more about autism.
Take care,