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Excerpts from Autism Speaks Canada website:
Medicines for treating autism are most effective when used in conjunction with behavioral therapies. Ideally, medicines are a complement to other treatment strategies…
Medicines for treating the three core symptoms of autism – communication difficulties, social challenges and repetitive behavior – have long represented a huge area of unmet need. Unfortunately, few drugs on the market today effectively relieve these symptoms and none of the options most often prescribed by practitioners work well for every individual.
In fact, while the Food and Drug Administration (FDA) has approved two drugs for treating irritability associated with the autism (risperidone and aripiprazole), it has yet to approve a medicine for treating autism’s three core characteristics. Nonetheless, medicines such as risperidone and aripiprazole can be beneficial… [note: there is no proven benefit to takers – SSRI Stories Ed]
The good news is that the range of medication options may soon change, thanks to recent advances in our understanding of the biology that produces autism’s core symptoms. This has made it possible for researchers to begin testing compounds that may help normalize crucial brain functions involved in autism. Early experiments suggest that several compounds with different mechanisms of action have great potential for clinical use, and many are now in clinical trials.
Although these developments are exciting and hold real promise for bettering the lives of people with autism, we will have to wait at least a few more years before we know if any of these drug studies produce enough information on safety and effectiveness to merit FDA approval for the treatment of core symptoms.
Today, most medicines prescribed to ease autism’s disabling symptoms are used “off label,” meaning that their FDA approval is for other, sometimes-related conditions such as attention deficit hyperactivity disorder (ADHD), sleep disturbances or depression. Such off-label use is common in virtually all areas of medicine and is usually done to relieve significant suffering in the absence of sufficiently large and targeted studies.
An example in autism would be the class of medicines known as selective serotonin re-uptake inhibitors (SSRIs), including fluoxetine. Several of these medicines are FDA-approved for the treatment of anxiety disorders and depression, in children as well as adults. Although large clinical trials have yet to demonstrate their effectiveness, parents and clinicians have found that they can ease social difficulties among some people with autism. However, it has proven to be difficult to predict which medicines in this class may produce the greatest benefit for a given patient with autism. Similarly, it can be challenging to determine the best dose.
Because using these medications in children and adolescents can be a difficult decision for parents, you may find it helpful to use our Medication Decision Tool Kit, a guide for actively working with a physician to find the approach that fits best with your values and goals. You can download it free here.
These are exciting times in the development of new medicines for relieving autism’s most disabling symptoms, and Autism Speaks is increasing its funding and focus in this promising area, while placing great emphasis on ensuring the safety of promising new medicines.
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Asperger syndrome has been associated with autism spectrum disorder, a complex neuro-biological disorder that affects the ability to verbalize thoughts, manage anxiety, cope with changes to routine and participate in unstructured social situations. Symptoms also include repetitive behaviours and fixations.
But violent behaviour is not typically associated with the disorder, said Margaret Spoelstra executive director of Autism Ontario.
“Autism and mental health (problems) are not synonymous. Autism is a neuro-biological disorder. But it is not about violence,” she said Tuesday. “Autism is not the reason someone gets behind the wheel of a van and plows through a crowd of people.”
Alek Minassian, 25, of Richmond Hill, is alleged to have been behind the wheel of a white rental van that struck pedestrians at Yonge St. and Finch Ave. He is facing charges in the deaths of 10 people, and attempted murder charges for 13 others who were injured.
In 2009, the Richmond Hill Liberal quoted Minassian’s mother Sona in a story about the loss of Helpmate, a local social service organization that helped her son, who she said has Asperger syndrome. The story did not name the son.
A 25-year-old who plowed a van into a crowded Toronto sidewalk was ordered held Tuesday on 10 counts of murder 13 of attempted murder. (The Associated Press)
However, Minassian’s classmates at Sixteenth Ave. Public School, Thornlea Secondary School and Seneca College, described him as socially awkward, someone who kept to himself and who would frequently fidget or twitch. He was also a computer whiz.
Asperger syndrome was dropped from the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5) in 2013. Any previous subcategories of autism, such as Asperger’s, are now defined as autism spectrum disorder or ASD.
“Obviously, this is such a tragedy at every level. I cannot even begin to imagine these families going through such an awful time realizing their loved ones are gone,” Spoelstra said in an interview.
“Then, of course, I think of this young man and his family and what sounds like . . . a very complex-needs young man who was, indeed, participating in society,” she added, referring to Minassian’s years as a student at Seneca College
Spoestra said she does not know Minassian or any of the challenges he may have been facing.
“But what we can say is that diagnostic criteria for autism does not include violent behaviour,” she said.
“Clearly something was happening for this young man that was disturbing him in a serious way,” she said. “What that was, is not known or understood at this point. We feel the same sense of shock and would never make an assumption that someone with autism would do this. So the reasons for this are something else.”
Mark Mendelson, a former lead detective with the Toronto Police homicide squad, said it is too early to speculate about motive. But a key part of the investigation in the coming days will be a forensic analysis of online activity, examining the websites he visited and posts he made online.
Minassian’s mental health will be an important factor going forward, he said, predicting that the accused killer may attempt to claim to be not criminally responsible in the deaths — a legal defence known as NCR.
“If you look at it for what it is, it would not surprise me if an NCR defence is on the minds of any lawyer he is going to get,” Mendelson said.
The Canadian Mental Health Association has also urged people against connecting mental illness with violence, noting that those who suffer from mental health challenges are far more likely to self-harm or be a victim of violence than to be violent themselves.
With files from Wendy Gillis