Medication and Asperger's Syndrome
There is no medication that treats Asperger's syndrome itself. Medication can, however, be helpful for managing co-occurring conditions that are very common in people with Asperger's, including anxiety, depression, ADHD, OCD, and sleep difficulties.
Anxiety and Depression
Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for anxiety and depression in people with Asperger's. These include medications such as fluoxetine, sertraline, and escitalopram. They can be effective, but some people with autism spectrum conditions show greater sensitivity to medications and may experience more side effects or respond to lower doses than typical. Starting with a lower dose and increasing slowly is a common approach.
ADHD
ADHD co-occurs with Asperger's syndrome quite frequently. Stimulant medications (such as methylphenidate or amphetamine salts) are commonly used for ADHD and can sometimes help with focus and attention in people with Asperger's as well. Non-stimulant options such as atomoxetine are also sometimes used. Response to these medications in people with Asperger's varies — some benefit significantly, others experience increased anxiety or other side effects.
Aggression and Irritability
In some cases, particularly where emotional dysregulation leads to significant behavioral challenges, medications such as risperidone or aripiprazole may be prescribed. These are atypical antipsychotics that have received FDA approval specifically for irritability associated with autism. They are not without significant side effects and are typically used when other approaches have not been sufficient.
Sleep Difficulties
Sleep problems are extremely common in people with Asperger's. Melatonin, available over the counter, is often the first recommendation for sleep onset difficulties. Prescription sleep medications may be used in more severe cases. Good sleep hygiene practices are also important and should be the first line of intervention.
What to Ask Your Doctor
When discussing medication with a physician or psychiatrist, useful questions include:
- What specific symptom or condition is this medication targeting?
- What are the common side effects, and which ones should prompt a call to you?
- Is there any reason this medication might work differently in someone with Asperger's?
- How will we know if it is working?
- What is the plan if it does not work or causes problems?
- Are there non-medication alternatives we should try first or alongside?
Monitoring
Close monitoring is important, particularly at the start of a new medication or when doses change. Keep a simple log of symptoms, sleep, mood, and any side effects. This information is invaluable to the prescribing doctor. Children, who may not be able to accurately report their own experiences, need careful observation by parents and teachers.