I walk in and out of my office and leave my cell phone sitting on my desk. Sometimes, the ringer is on, but often I have it off to keep Mr. Snoopster from grabbing the phone or sticking his face in between me and my phone. Consequently, from time to time, I will miss a call when I am down the hall and my ringer is off.
Today, I missed a call I really wished I had not missed. It was the neurology office. They left me a message telling me they wanted to go over test results from my son’s genetic testing and his “micro-array”. (Why do they leave these messages precisely at noon?) When I called back, the person who called me was at lunch.
I got no return call for the rest of the day and was reduced to wondering what I would be told. This is how I ended up back at the book my neurologist wrote. It’s a handy reference guide to his method of assessing patients, defining for his patients’ parents what he is doing, the tests he is ordering and why, and what the potential benefits of his methods can yield in terms of diagnoses and treatment.
And that is how I came to this post.
The genetics chapter gave me no information of useful consequence. However, I did end up at Chapter 23 which is titled “Medications for Core Symptoms of Language and Behavior”. I learned about the various medications he uses, generally, and what they can do for a child with ASD when prescribed under the right circumstances. Because this information is so valuable, I want to share it with you.
So, here’s the rundown of the medications discussed by my neurologist in his book and what they have potential to do as I understand it. Keep in mind, I am just one mom reading a book. I am NOT in the medical profession. I have no experience in whether these medications work or don’t or when they should or should not be used.
MEDICATION IS AN INDIVIDUAL ISSUE. ALWAYS CONSULT WITH YOUR MEDICAL PROFESSIONAL TO DETERMINE WHETHER MEDICATION IS APPROPRIATE FOR YOUR CHILD.
Depakote (valproic acid) –
Some neurologists do not agree on the use of this medication. However, as I understand it, this medication is used where there is an abnormal EEG, showing abnormal spikes (seizures) during sleep, where no clinical epilepsy has been diagnosed.
From what I read, the drug has shown about a 70 percent improvement on normalizing an EEG and in receptive speech processing. The usual trial period for assessing this treatment is 8-12 weeks.
AFTER EEG NORMALIZATION OR WITH A NORMAL EEG MEDICATIONS-
L-carnosine – This is a natural dipeptide (amino acid) found in the brain that also acts as a neuro-protective protein. It can block excess copper and zinc influx during cell inflammation or a deficient blood supply (ischemia). It can also act as an anti-oxidant protective supplement in the brain.
There are published studies showing improved behavior and receptive language processing in autism. It can cause irritability (20-30 percent of cases) but no other physical side effects. In a rare metabolic disorder, this medication is not used.
Aricept – Apparently, this can increase acetyl choline in the frontal lobes of the brain which may be deficient in autism. It has been shown to improve behavior and receptive language with some expressive language improvement in 50-60 percent of treated children with ASD.
Exelon – Shorter duration drug like Aricept. In a study, it has shown effect upon receptive and expressive language and improved behavior and slightly improved attention. Also with the side effect of irritability in 30 percent and gastrointestinal problems in 10-20 percent.
Memantine- Over 400 children with autism have been treated with this drug and over 80 percent have shown improved social behavior and interests and better receptive and expressive language. Some have seen better motor processing with dyspraxia (problems with movement and coordination). Only 10-15 percent show irritability or hyper behavior exacerbation and no other physical side effects have been noted.
Steroids – The side effects of these medications have to be closely monitored and these medications are recommended only in rare circumstances. They have been reported to help speech and language as well as social awareness and empathy.
Of course, you must be followed by a physician who specializes in knowing how to diagnose and treat autism. I am lucky to have (finally) found one who I respect. Obviously, each ASD child is different and requires different treatment.
In fact, in his book, our neurologist talks about actual case studies in general terms to give an idea of the many different ways autism manifests itself. Some of those ways include regression or no regression, boys versus girls and presentation through Fragile X or Rett Syndrome, Asperger’s and “classic” ASD. Each case emphasizes how differently ASD is manifested in each person affected.
I hope this information may be useful to someone who may have an upcoming neurology visit to discuss options. I plan to bring these up at our next follow up appointment, but I’m pretty sure my son’s doc will do it before I say a word.