Q: My son has been diagnosed with Asperger's syndrome or high functioning autism as the doctor says. He was being given Rispid for the past one year after which his communication abilities improved. He has done his KG and first standard from a normal school. We are still facing lots of problems, like he is not able to mix up with other students. He is gaining weight after taking this medicine along with pacitane. Is this combination safe? What should we do next?

A:Rispid is the brand name of a medicine called risperidone. It is used in the treatment of psychotic disorders and is not used for Asperger's syndrome. Moreover it is not allowed to be used in patients below 15 years due to its serious side effects. Similarly Pacitane is the brand name that contains a medicine called trihexyphenidyl. It is used in the treatment of Parkinsonism and drug-induced muscular movements. It is not used for Aspergers syndrome. Your son is gaining weight due to Rispid. Your son has improved because that is the normal course of the disease, not because of medicines. For your information, I give below the exracts from an article on Autism and Aspergers syndrome that appeared in the Monthly Index of Medical Specialities (MIMS) on May 31, 2005. It is very important that parents understand exactly the nature and course of the disorder: Asperger’s syndrome: was first described by the Austrian physician Hans Asperger in 1944, about the same time that Kanner described autism, but it was not properly recognised as a unique disorder until 1994. People with Asperger’s syndrome have a history of little or no delay in the development of vocabulary and overall have average or above-average cognitive abilities. There is no significant general delay in language development, such as the use of single words by the age of two and communicative phrases by the age of three, but later language is often pedantic, with long-winded speech and intonation abnormalities. Social difficulties: Those affected by Asperger’s syndrome have difficulties with social interaction but, in contrast to those with classic autism, they are often interested in other people but have difficulties understanding the ‘how to’ of social communication. An example might be a boy who does not know how to go about making friends. Others may tease him and find him boring and odd, and he may be bullied at school or feel isolated. Sufferers from Asperger’s syndrome are often perceived by their peers as ‘different’, and this is very distressing for them. This is exacerbated by the fact that they usually have restricted and often unusual interests (such as a fascination with timetables) and repetitive behaviours. Many affected individuals have poor motor skills that are often perceived as clumsy. Sometimes excessive sensitivities to sensations are reported, and another phenomenon is excessive but non-interactive speech related to an area of special interest to the child. Differential diagnosis: It may sometimes be necessary to rule out other possibilities when diagnosing Asperger’s syndrome. These would include age-appropriate behaviours in active children, mild degrees of mental retardation and children who are being raised in under-stimulating environments. Parents of children with autistic spectrum disorders find the confirmation of the diagnosis extremely helpful, despite experiencing grief at the formal recognition that their child has a chronic, disabling condition. Some parents worry that a diagnosis may be stigmatising. This is more commonly felt by parents of children with Asperger’s syndrome, especially if the difficulties are subtle. Management: Early diagnosis offers the child the chance to develop language, social communication and play skills. Behaviour management helps build life skills and reduce future problem behaviours. Communication skills: Increasing the communication skills of children with autism is essential, and is often done through speech and language therapy in an educational environment. Signing systems and picture exchange communication systems are useful if language is absent or minimal. Treatment for co-morbid psychiatric disorders such as hyperactivity or depression can be provided. Many children with autism develop epilepsy at some stage. Medication: The role of medication is small and reserved for associated problems such as self-harm behaviour, hyperactivity or repetitive behaviours. First-line treatment is with behavioural management strategies. There is no cure, but skilled multi-agency support can improve the quality of life of affected children and their families.