Guide to starting new psychiatric medication for Autistic people

This article is not intended as medical advice, please speak to your prescriber for any medical questions pertaining to medication. This article is something of a survival guide based on my own experiences, other’s experiences may differ.

Recently I started a new medication on the advice of my psychiatrist. This is the event that has acted as somewhat of a catalyst for this article.

As Autistic people, we often find ourselves taking psychiatric medication for a plethora of reasons. However, our experience of these medications is (anecdotally) often vastly different to that of our non-Autistic peers.

This bring me to my first point. Many Autistic people report having rare or paradoxical reactions to medications. Paradoxical reactions usually involve the effect or side effect being the polar opposite of that which is expected. Commonly this is seen in ADHDers with stimulants, and is in fact what underpins their use in the support of those of that particular neurotype.

However, trying to get your doctor/prescriber to understand your paradoxical reaction when it is unexpected can be very difficult. You have to be prepared to advocate for yourself. If a side effect is intolerable, do not be afraid to speak to your medic.

Something else to consider is that many of us report being very sensitive to medications, especially during the initial titration period. I personally always ask my doctors to stick to the rule “start low and go slow”. I find it helps to avoid intolerable side effects during the titration period, and allows me to better evaluate when a medication is working, and what the minimum dose I need to see a result is.

Don’t be afraid to learn about medications, but before to include your prescriber in your learning. They are the expert on medications. That said, you are the expert on yourself, so always be prepared to advocate for yourself. When starting a new medication, I tend to familiarise myself with the most common side effects, and any warning signs that I am having a dangerous reaction to the medication. After that point I will only consult the side effects leaflet if something unexpected happens. I find that this helps reduce anxiety around medication changes.

You don’t want to spend the first two weeks of titration constantly assessing yourself for every side effect, it’s exhausting.

This bring me onto my final point, starting new medications can be taxing on your spoons. Try to start medications when you have the opportunity to do nice things for yourself. Look for opportunities to rest and recuperate those spoons that you have expended. This won’t be feasible for everyone, but please do your best.

As I mentioned at the beginning, this is based on my own experiences. Yours may differ, and if you have an insight that you feel I have missed, please do feel free to drop it in the comments. We all learn from each other.

Finally, remember; sometimes medication is necessary. It’s okay to need this accomodation, and the only two people whose opinions should matter in this debate are primarily your own, but also your prescriber.

Do not allow space for the med-shamers.

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