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What drugs are useful in controlling hyperactivity in autistic children?

Q: My 10 year old daughter is autistic. She has days when she is hyperactive which I am told is a feature in autism. She has become very aggressive also. She was given Methylphenidate (Ritalin) when she was around 5 years old to control her hyperactivity but it did not go well with her which the doctor said was probably because she is not hyperactive all the time and hence Ritalin had adverse effects on her on days or times when she was not in a hyper state. I was asked to discontinue the drug. Last month I was advised to give her Haloperidol to control her aggression. The drug did work on the first day but on the second day she reacted to the drug and I was asked to stop it by the doctor. Her increasing aggression is a major cause of concern. She is not self injurious but she does hit people around and her younger brother and is uncontrollable at times. A doctor on the panel of DoctorNDTV from NIMHANS Bangalore had answered my query on the programme and said that new drugs are now available which can help control hyperactivity and aggression in autistic children. You are requested to kindly give me information about these drugs which can help my daughter.

A:It is extremely difficult and potentially dangerous to use new drugs in children in general and more particularly in children with autism. New medicines have both known and unknown side effects. Children suffering from autism can neither appreciate nor communicate side effects. Therefore it is always safer to use conventional, well tried and tested medicines. Furthermore, no new medicine has been launched specifically for behavioural problems in children with autism. Some general medicines such as clomethiazole and pericyazine have been introduced for use in aggression but they are not recommended for use in children due to lack of safety data. Your doctor is absolutely correct in prescribing haloperidol (brand name: Serenace - RPG Life). One of its uncommon side effects is extrapyramidal disorder (such as persistent involuntary retraction of neck) which can be easily seen by carers. In such an eventuality, the medication must be stopped forthwith. The dose is 0.025 to 0.05mg per kg of the patients body weight divided in two doses (morning and evening). Methylphenidate is indicated and approved for use in Attention Deficit Hyperactivity Disorder (ADHD) only.

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