Autism Information Library

Psychiatric Medications and Autism

I have seen an alarming increase in discussion about psychiatric medications "for autism" or for parents' autistic children, as if it is a trivial matter. It is not. As a result, I have written this, which talks about psychiatric medications and gives guidelines for their use. My views on this have been discounted as being too extreme or absolute. It is not wrong to have extreme or absolute views, particularly in a matter which affects one personally, and not peripherally (I am autistic; I am not a parent watching an autistic). I have had doctors ask me before, what various psychiatric medications do, and have been consulted with about the use and misuse of such medications. Basically, I have had doctors admit that I know more than they do about the subject.

For anyone wondering, here are my "Credentials" for speaking about these things.

Note: The terms "meds" and "psych meds" may be used as abbreviations for "medications" and "psychiatric medications" throughout these documents. Since this was originally written directed at parents of autistic children, I have often used the word "child" to apply to the autistic who would be taking the medications. This applies just as well to autistics of any age.

One of the important things about psychiatric (in particular) medications is that they should always be the choice of the person taking them, whether to take them or not. They should never be the choice of parents, teachers, or doctors.

An important aspect of that choice is it being a free choice -- free of coercion from other people. It is easy for a doctor to continue to bring up the subject of medication, until it sounds like the medication is somehow good for the patient (which may or may not be true). In this way, a patient may give "informed consent" on a medication that a doctor has been assuring them will do them good -- some doctors go even further and say that there is no hope for a patient without the medication. A patient can also be coerced into taking medication "for a trial period", during which time even side-effects of the medication may be taken as signs the patient "needs more", or the "trial period" might end abruptly enough to cause withdrawal, which may "prove" the point that "the patient needs medications." These things can influence a patient to believe it is true, when in fact it is not.

It seems to be a common belief right now that it is the parents' choice to put their children on psychiatric medications or not. This belief is common even among doctors. What this means, for parents talking to these doctors (and teachers possibly, as well) is that the parent needs to be aware that it is truly their child's right to take or refuse medication, whether or not it is a currently enforced legal right. If the child is unable to give informed consent, the child should not take psychiatric meds.

Also, the reason for the meds, if they are taken at all, should never be that they are because of the difficulty that parents, teachers, or others have with the child's behavior. The only reason that meds should be taken at all, is if the child themself wants the meds, and is reasonably informed about the meds involved.

(Note: "Reasonably informed" means actually able to understand the full implications of the medications. It does not mean being told "this medication will make you feel better" or "this class of medication will make you feel better" or any form or degree of coercion on the doctor's part.)

Also, certain kinds of medications (specifically, antipsychotics) should never be used "for autism" or at all in a child, or in an autistic. Doctors may say other things on this matter (as a matter of fact, many doctors right now are recommending these meds in autistics), but the truth is that antipsychotics dull cognitive proceses. When a child is developing, they need all the cognitive processes they can get. When a child is autistic and developing, they really need all the cognitive processes they can get, to cope with the world and grow mentally.

Note that while some autistics have talked about being helped (for other conditions than autism -- anxiety and depression being the most common) by psychiatric medications, they aren't talking about the antipsychotics (most of us just have horror stories for those). They're usually talking about antidepressants.

So, I will write a list of guidelines I can think of, for giving psych meds to autistics (note: I am not talking about medications for life-threatening non-psychiatric conditions (illness or certain forms of epilepsy) but specifically medications for psychiatric conditions and purposes. However, what I say about antipsychotics is true regardless of purpose.)

Inadequate reasons for psych meds

Situations which must be fulfilled to make psych meds a possiblity

At the moment, it is considered a parent's choice what to do with their child's brain. This is not true. It is not the parents' choice, the doctors' choice, or the teachers' choice. It is always the autistic's choice. Because it is considered to be okay to choose these things for their children, and because it is the right of the children to choose what psychiatric medications to take, it is the responsibility (at the moment) of the parents or caregivers to make sure that it is the child's decision, and to make it known that it will be their child, not themselves, making any choices regarding psychiatric medication. In this way, the child will be able to keep their rights, and will be a more independent person. I suspect also that children who are able to make choices, will trust their parents more than they would trust parents who made choices for them. I hope someday it will be widely recognized that a person has these rights on their own, regardless of age or disability. It is important, especially for those of us who are at the receiving end of these medications and other "treatments".