Question 1

How do I treat ADHD when my patient also has autism?

Accepted Answer

The comorbid AuDHD population responds to stimulants but tolerates them poorly - 18-19% cannot complete titration due to irritability, emotional lability, and insomnia, and nearly half discontinue within six months. This reduced tolerability supports a lower threshold for first-line non-stimulant use.

Question 2

Should I start with a stimulant or guanfacine in an AuDHD patient?

Accepted Answer

The comorbid AuDHD population responds to stimulants but tolerates them poorly - 18-19% cannot complete titration due to irritability, emotional lability, and insomnia, and nearly half discontinue within six months. This reduced tolerability supports a lower threshold for first-line non-stimulant use.

Question 3

What does the RUPP Autism Network study show about stimulant tolerability in ASD?

Accepted Answer

The comorbid AuDHD population responds to stimulants but tolerates them poorly - 18-19% cannot complete titration due to irritability, emotional lability, and insomnia, and nearly half discontinue within six months. This reduced tolerability supports a lower threshold for first-line non-stimulant use.

Question 4

Why does stimulant treatment sometimes seem to worsen autistic traits?

Accepted Answer

The comorbid AuDHD population responds to stimulants but tolerates them poorly - 18-19% cannot complete titration due to irritability, emotional lability, and insomnia, and nearly half discontinue within six months. This reduced tolerability supports a lower threshold for first-line non-stimulant use.

Question 5

What is the medication sequencing algorithm for AuDHD?

Accepted Answer

The comorbid AuDHD population responds to stimulants but tolerates them poorly - 18-19% cannot complete titration due to irritability, emotional lability, and insomnia, and nearly half discontinue within six months. This reduced tolerability supports a lower threshold for first-line non-stimulant use.

Question 6

When should I combine guanfacine with a stimulant in AuDHD?

Accepted Answer

The comorbid AuDHD population responds to stimulants but tolerates them poorly - 18-19% cannot complete titration due to irritability, emotional lability, and insomnia, and nearly half discontinue within six months. This reduced tolerability supports a lower threshold for first-line non-stimulant use.

PsychHQ

Treating ADHD in the AuDHD Patient - Medication Selection and Sequencing