FASlink Fetal Alcohol Disorders Society


Medications for Children and Adults with FASD

The following information is gathered from medical experts who have successfully treated children and adults with Fetal Alcohol Spectrum Disorders (FASD), including Fetal Alcohol Syndrome(FAS) and Fetal Alcohol Effects (FAE) with or without other neurological disorders like obsessions, compulsions, aggression, that interfere with the person's ability to function in life. Behavior problems are due in part to imbalance of chemicals in the brain caused by prenatal exposure to alcohol.

Many doctors with recognized expertise in FASD recommend that, in general, most kids with FASD do best with a combination of Stimulant + Selective Seratonin Receptive Inhibitor (SSRI) . One exception is the child who has Bipolar disorder in addition to the FASD, in which case stimulants and/or SSRIs may cause an increase in behavior problems. (See note on "co-occurring conditions" below.) Many doctors also prescribe Clonidine (Catapres) for children who have problems with sleep, anxiety, or aggression in addition to the hyperactivity.

Stimulants that seem to be effective include Adderall, Ritalin, Concerta, or Dexadrine. SSRI's most commonly prescribed are Paxil, Prozac, Zoloft, and Celexa. Stimulants are reported to be effective 80%-90% of the time, when a correct diagnosis of FASD has been made, and if they are prescribed properly. These psychostimulants are probably among the safest medications available and have few potential side effects. Stimulants may reduce appetite, but the SSRI's usually counter that effect. Increase opportunities to eat during the time the stimulants have worn off. Several other medications can be tried instead of or in addition to these, but it might be wise to try the Stimulant-SSRI combination first.

Medications that have been prescribed to successfully treat children and adults with FASD include:

Abilify (aripiprazole) antipsychotic, for Bipolar
Adapin, Sinequan (doxepin) antidepressant
Adderall (Dextroamphetamine) for ADHD
Amantadine (Symmetrel) dopamine booster
Anafranil (clomipramine) antidepressant, for OCD
Benzodiazepines for anxiety
Buspar (buspirone) for anxiety
Carbamazepine for episodic outbursts and aggression
Catapres (clonidine) for anxiety, ADD
Celexa (citalopram hydrobromide) for depression
Clozaril (clozapine) reduces suicide risk in schizophrenia
Compazine (prochlorperazine)
Concerta (time released Ritalin) for ADHD
Cylert (pemoline) for ADHD (may cause serious liver problems)
Dalmane (flurazepam) for sleep disturbances, anxiety
Depakote (Divalproex, Valproic Acid) anticonvulsant, ODD, aggression
Desyrel (trazodone) antidepressant
Desoxyn (methamphetamine) stimulant for ADHD, narcolepsy
Dexedrine (dextroamphetamine) psychostimulant for ADHD
Effexor (venlafaxine) anti-depressant
Elavil (amitriptyline) - another antidepressant
Eqanil, Miltown (Meprobamate) for anxiety
Haldol (haloperidol) for explosiveness
Klonopin (clonazepan) for anxiety
Lamictal (lamotrigine) anticonvulsant, mood stabilizer
Librium (chlordiazepoxide) for Bipolar
Lithane Lithotabs (lithium) antipsychotic, bipolar
Luvox (Floxyfral, fluvoxamine) for OCD
Mellaril (thioridozine) for hyperkinesis
Molindone (Lidone, Moban) antipsychotic (no weight gain)
Neurontin (gabapentin) anti-convulsant, anxiety, panic
Norpramin (desipramine) another antidepressant
Paxil (paroxetine) antidepressant
Phenergan (promethazine)
Prozac (fluoxetine) antidepressant
Provigil (modafinil) for ADHD, narcolepsy, sleep apnea (does not suppress appetite)
Remeron (mirtazapine) antidepressant (may increase appetite)
ReVia (naltrexone) skin picking
Risperdal (risperidone) antipsychotic (causes weight gain)
Ritalin (methylphenidate) for ADHD
Seroquel (quetiapine fumarate) antipsychotic (may increase appetite)
Serzone (Nefazodone) antidepressant, also for seizures
Stelazine (trifluoperazine)
Strattera (atomoxetine) non-stimulant for ADHD
Tegretol (carbamazepine) mood stabilizer
Thorazine (chlorpromazine) for aggressive, very agitative behavior
Tofranil (imipramine) antidepressant, good for enuresis
Tomoxetine for ADHD (non stimulant)
Trileptal mood stabilizer for Bipolar
Valium (diazepam) for epilepsy, CP spasticity, anxiety
Wellbutrin (bupropion) anti-depressant
Xanax (alprazolam) for anxiety disorders and aggression
Ziprasidone (Geodon) antispychotic
Zoloft (sertraline) antidepressant
Zyprexa (olanzapine) antispychotic
For a more complete list of commonly prescribed psychotherapeutic medications, read the booklet "Medications" published by the National Institute of Mental Health. Refer to NAMI for credible information about mental health issues.

Refer to this 2002 Medscape Today article for a report on new meds being prescribed for individuals with FASD.

Note about stimulants: Adderall is similar to Dexadrine in that it is a combination of amphetamine salts. It has been around for 20 years, but has been used for ADHD in only the last five years, so some doctors are not familiar with its use for ADHD. It has been prescribed for use in children as young as three years of age. Adderall lasts longer (6-8 hours) than Ritalin (2-3 hours), and produces fewer mood swings. More on how stimulants work: http://www.sciencedaily.com/releases/2001/01/010117075041.htm.

Note about generic Ritalin (methylphenidate): Many parents and report that the generic methylphenidate is not as effective as name brand Ritalin. The generic is not always as potent as Ritalin (allowed by the FDA), and some manufacturers add coloring which could adversely affect behavior. Ritalin only lasts 2-3 hours, so a dose at 7 a.m. will only last until 9:30 or 10 a.m., two hours before the usual lunch time dose. Because of these reasons, many doctors prefer to prescribe Adderall. More on Ritalin: http://www.come-over.to/fasstar/Ritalin.htm

Note about anti-depressants: SSRI's are commonly prescribed for depression, but they also effective in treating ADHD and behavior problems such as outbursts, aggression, and compulsive behaviors. The dose might even be higher than the usual dose for depression.

Note about antipsychotics: Some antipsychotics may increase appetite and lead to weight gain. However, obesity is linked to diabetes. Medications to monitor for this risk factor include Risperdal, Seroquel, Abilify, Geodon, Clozaril, and Zyprexa. For this reason, blood sugar levels should be monitored. But weight increase becomes a problem, then Moban or Lamictal might be a better choice. (Revised 9/26/03)

Sources: Dr. Calvin Sumner (WV); Dan Dubovsky, researcher; Dr. Kieran O'Malley (1997) Iceberg Newsletter 7(4).

Last Update: April 4, 2004

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