Pharmacotherapy – Autism Spectrum Disorder (ASD) (Nursing)

00:00 Pharmacotherapy. Oftentimes when we're thinking about a person who has a mental illness or a psychiatric disorder, we think there must be medicine for that but no pharmacotherapy has been demonstrated to be efficacious for treating the core symptoms of ASD. Evidence-based pharmacotherapy for children is right at this time still incredibly limited so we look and assess those behavioral and emotional symptoms and then what we medicate is ways to help reduce these intense emotions or some of these behaviors that are seen. This is also used not just for children with ASD but also with adults. One of the types of medications that we use with ASD may be the atypical antipsychotics.

01:04 Usually, we use risperidone or aripiprazole and what they do is they reduce the irritability, they reduce the hyperactivity, and they reduce some of those stereotypical behaviors that we see with ASD. We also may be using the methylphenidates in order to reduce attention-deficit hyperactive symptoms. When we look at using methylphenidate or atomoxetine, and even the alpha-2 agonists, what we find is that it calms those ADHD or attention-deficit hyperactive disorder behaviors where the child is unable to calm down and remain still. What are some of the negative outcomes if we're using pharmacy and different medications to deal with the behaviors and the emotional disruptions that occur with ASD? Well, the same negative outcomes from antipsychotics that are seen when we use them for schizophrenia are also seen when we use them for ASD. We're going to see the weight gain, the dyslipidemia with atypical antipsychotics. With some of the selective serotonin reuptake inhibitors, the SSRIs, we find that they don't even work on reducing some of those symptoms. They actually increase adverse events because the child may have a reaction to the medication that is not the normal sedative or antidepressive kind of response. So while there are no approved medications to treat the core symptoms of ASD, we do use some of the following medications just to treat, for example, the irritability. So as I said before, the risperidone which is the antipsychotic, we use it in children and adolescents between the ages of 5 and 16 years old, but we must monitor them for neuroleptic malignant syndrome. We must look for if they're having suddenly a fever. Right? We would have to look for tardive dyskinesia or those automatic involuntary movements or shuffling gait. We have to monitor them for hyperglycemia and diabetes because we know that the antipsychotics do come with the problem of metabolic disease. Abilify or aripiprazole is another antipsychotic that we use and it's used in children from 6-17 years old and these children on Abilify might have incredible sedation, fatigue. They will also have that weight gain. They might have some vomiting, exhaustions, tremors, somnolence. When we have children who have ASD, it's important to look at the child, not the diagnosis, to consider the needs of the child and to understand this is a chronic lifelong condition that the parents are going to be working with medicine and social work and all of the other possible support systems that they can garner in their communities. And so when they bring the child into the hospital and they give us their child to watch over. Being able to see the child first and assess the child is our most important attribute.