So here's something I would like to share. As it relates to myself by how I'm not really sure if I have ADD, or if im in some sort of autistic fog.

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Stimulant treatment among autistic children, adolescents, and adults is a highly controversial subject. I will neither endorse nor oppose their use – I speak only for myself. However, I feel no shame in admitting that this class of medications quite literally saved my life.

Due to my lifelong hyperactivity, lack of motivation, spastically robotic social skills, and failing grades, I was finally placed on an amphetamine medication. Prior to beginning amphetamine treatment I was utterly hopeless, overwhelmed by even the simplest of daily tasks. An MRI would have likely revealed a plate of scrambled eggs where my brain should have been.

When it comes to the daily dance of manners, I’m afraid I have two left feet. My impulsiveness is epic – I always appear to be six beers deep. I’m obnoxious, disorganized, obsessive, and restless. Are these symptoms of autism? ADHD? Both? More importantly, are they distressing enough to warrant psychiatric intervention?

What is autism? What is ADHD? Are they distinct syndromes that happen to overlap or nothing more than a collection of comparable symptoms lumped together for the sake of convenience. As Connie Erbert (Director of Care and Autism Outreach, Heartspring) told me, “It’s not about treating labels. Labels aren’t people. It’s about treating symptoms. “

My first conversation with New York Times bestselling author and fellow aspergian John Elder Robison was characteristically singleminded. I figured Robison would have a fascinating history of psychopharmaceutical treatment. I was disappointed to discover that he has remained religiously unmedicated, aside from the occasional puff of an asthma inhaler. He did, however, offer some choice words regarding the connection between autism and ADHD, “One day when we have unravelled the autism puzzle, I predict we will find ADHD is rolled in there somewhere, as a subset of the spectrum.”

When faced with the mounting pressures of a competitive and unforgiving world, many autistics choose psychiatric assistance. Clarity, motivation, and heightened executive functioning are often obtained through the use of popular stimulants approved for the treatment of ADHD. According to “Asperger Syndrome: intervening in schools, clinics and communities,” by Linda J. Baker and Lawrence A. Welkowitz, “The ADHD-like symptoms associated with ASD often seriously interfere with the effectiveness of functioning and the ability to utilize behavioral and educational interventions in the ASD population. Therefore it is not surprising that many of the pharmacological agents used in the treatment of ADHD are frequently tried in this population.”

Stimulants of the amphetamine (Adderall, Dexedrine, Vyvanse) and methylphenidate (Ritalin, Focalin, Concerta) families are useful tools, and occasionally lifesaving treatments. Unfortunately, these “uppers” are also coveted recreational drugs, cherished by every frat boy desperate to write an important paper after crawling out of bed in a Coors Light and bong smoke flavored haze.

Whether used or abused, stimulants remain pharmaceutical celebrities among a generation raised on Cocoa Puffs and midday visits to the school nurse for a booster dose of Ritalin. But can these powerful medications truly assist an autistic individual? If so, what specific benefits may be expected, what are the potential side-effects, and which particular medications are the most effective? The answers to these questions depend on who you ask.

Shanti Roy, an Australian autistic and Ritalin user, often discusses her symptoms and methods of treatment in her popular blog, “Platform 25″. Her candid responses to my questions highlight the ups and downs of life on therapeutic uppers, “As someone with co-morbid ADHD, I benefit greatly from the medication. I am able to organise myself, process written information, have better control over emotions, increased memory, and even have a willingness to socialize!”

However, Roy’s treatment has not been without its share of unwanted effects. “I’ve had all sorts of uncomfortable side effects, such as overstimulation, increased anxiety, facial tics, appetite suppression, etc…” Despite these troublesome side-effects, Roy believes the benefits have greatly outweighed any discomfort. Would she give up her Ritalin? “Hell no!”

Roy’s enthusiasm is supported by a substantial number of peer reviewed studies. One such study, “Efficacy of Methylphenidate Among Children with Autism and Symptoms of Attention-Deficit Hyperactivity Disorder” by Benjamin L. Handen, Cynthia R. Johnson and Martin Lubetsky, included twelve test subjects. “…eight subjects responded positively, based upon a minimum 50% decrease on the Conners Hyperactivity Index. Ratings of stereotypy and inappropriate speech, which are often associated with autistic core features, also decreased.”

Are the symptoms of autism and ADHD to be celebrated or medicated? Like Alex Plank, I am proud of who I am, neurological miswiring and all. However, Asperger Syndrome and ADHD can be a downright pain in the *** sometimes. I do not take stimulants in an effort to disguise my unique and wonderful attributes. My medication enhances my singular abilities and minimizes my deficits. In other words, medication doesn’t change who I am… it allows me to be the best version of myself.

As mentioned, I cannot tolerate methylphenidate and quickly discontinued its use. Next came Vyvanse; a wonderful medication… for about a month. It pooped out unexpectedly and I moved on to Adderall (mixed amphetamine salts). I now avoid that one as well due to the levoamphetamine which comprises 25% of each dose. Levoamphetamine is the left handed isomer of the amphetamine molecule, and constitutes 50% of amphetamine in it’s organic form. Levoamphetamine has a significant impact on the peripheral nervous system, resulting in anxiety, restlessness, muscle tension, irritability, strong physical stimulation, and obsessive compulsive behaviors. Are those really autism friendly effects? I suffer enough of those symptoms without drugs.

Dextroamphetamine is the dextrorotatory isomer, isolated from it’s levorotatory twin and sold under the brand name Dexedrine. Dexedrine is far more CNS specific, resulting in stronger mental effects and decreased physical stimulation, anxiety, etc… Though infrequently prescribed, it remains an excellent alternative for those too sensitive to the nastier effects of Adderall.

It’s humbling to stare into a bottle of pills each morning knowing full well that I’d be an utter failure without them. Nevertheless, I swallow my pride… and my pills. “Man up” may have worked for my father, but I’m not organically equipped with that good ol’ American machismo. Besides, even John Wayne drank whiskey.
My medications greatly improve my quality of my life. This does not mean stimulants are appropriate treatment options for just anyone. They have the power to both save and destroy lives. My own experiences are just that… MY experiences. Remember, no drug is a perfect fit for any diagnosis. We must treat symptoms, not labels. One, several, or none of the currently marketed stimulants may be of benefit. If reading this article inspires you to seek treatment for yourself or your child, I applaud your bravery and wish you the best of luck. However, if you pop your first dose of Adderall and wake the next morning in a cold cell, half naked, and handcuffed to Lindsay Lohan… just remember that I am in no way responsible. Oh, and get me Lohan’s autograph when she has a free hand.

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In my own opinion, I don’t think a parent has a right to make these decisions for a child, especially one with an impaired ability to communicate.

But some people are being treated and it works, like myself. So it'll be good in the future when we come to understand the effects of meds and more about autism

[MikeDelta]

I definitely think its a tricky subject, especially can it go off the chains so quickly. I did well on concerta other than fatigue. But I ended up having an episode and that was enough for my pdoc to say no more. Adderrall was bad from the get go. I just couldnt tolerate stimulants.
My big issue is the side effects from the stimulants. Some of the stuff is pretty icky. It is something I think they people in charge need to look at and find a way to create something better.
I wont lie I dislike taking medication but finding something that "Works" makes me feel a bit more comfortable. I am generally against all prescriptions without trying other options first just because I dont 100% traditional medicine. Which is why it took me a year just to get on a SSRI. But like I said, when something works, It is a bit easier to handle.

I dont like PArents making big decisions for their kids like that but then again I was in the boat where my parents refused to do Anything. I think it is a fine line.

Great post, very informative

I know I'm afraid of what the prozac at such a high dose is doing to me and I can't eat on concerta its a real pain in the *** I'm afraid he'll take it away because i lost 3 pounds in a week when i was trying to GAIN weight.

I know the risperidone at 2mg instead of 1mg was making my ADD worse and making very sleepy.

It's like they are eating away at my brain :/

[Lexi232]

As a young kid the stimulants didn't help me, they made things worse. I was already having issues with the whole overwhelming on my senses thing, but i believe that the stimulant made it worse as it made me even MORE aware of my senses. I would cry as soon as it kicked in ...
Now though, It helps. without it, it go back to being more "within my own world" and having a almost impossible task of trying to communicate with spoken words.
But then i'm also on meds that counter act some things that the stimulant causes. (such as when it first kicks in, i go into manic mode almost, because i take both vyvanse and the ssri of viibryd. (viibryd for depression, which usually is caused by me not taking vyvanse (i isolate and feel even more alienated than whats normal for me now). Then when i was being changed around on meds this last time (over a year ago), i was thought to have bipolar because they had too many "feel good" meds in my system (strattera, cymbalta, viibryd, vyvanse, ritalin, - and i think that's it, tho i feel like i'm forgetting one). And then they put me on seroquil 4 times a day to treat the "manic episodes" and then when it was just viibryd and vyvanse in my system i became beyond the depressed state (as in i didn't eat, didn't use the potty, didn't move, didn't open my eyes.. ) and they took me off of 3 doses of seroquil and kept the one at night for a sleeping med. (which also makes the vyvanse not so manic in me during the few first hours in the morning. Then i eventually become even level at evening time, and in the morning i start all over again)... i'm also on lamictal at night for seizures.
But with the meds it has its pro's and cons.. it helps me be able to socialize and atleast speak most of the time, whereas I would normally say up to five words a day and those few would be painfully difficult (as I would be putting all of my effort into speaking for most of the day).
but I have to go through the med cycle every day.. I guess it just depends on what you value more...

I'm sorry if i haven't made much sense. But i wanted to let you know that I'm one that also finds that it helps.;-) so your not alone.
(ditto on the parent making big decisions thing. I think a kid should know who they really are, and get to know themselves before being put on mind altering medications. But then at the same time, parents doing nothing or denying anything to do with a diagnosis or meds isn't good either. There is a middle ground to that.. )

This is just my own personal experiences and my opinions. :-)