Let’s admit it: we don’t usually think about acid reflux medications, laxatives, stool softeners, meds to fight off diarrhea, or manage irritable bowel syndrome when we think about what might be affecting our driving readiness. Many autistic teens and adults take at least one of these regularly, often without giving driving a second thought, because guess what? Being autistic, you’re much more likely to experience gastrointestinal problems than your non-autistic friends.1,2,3
This category isn’t the scary one, but…
Of all the medication groups we’ve talked about so far, this one tends to cause the fewest driving problems.
If you struggle with frequent heartburn, chances are you rely on a Proton Pump Inhibitor (PPI) like omeprazole (Prilosec) or esomeprazole (Nexium) for powerful, long-lasting acid suppression.
Most reflux medications aren’t doing much to your brain. They’re working in your stomach, not your nervous system, so most people notice little if anything that would affect driving.
However, there’s always going to be someone who gets mild side effects like dizziness, headaches, or unexpected drowsiness, particularly when you first start taking them.
One of the biggest driving risks in this category isn’t necessarily the medication itself.
It’s what you feel like when you’re NOT taking them.
Think about what severe acid reflux feels like. Burning pain. Discomfort. Sleep disruption.
Now imagine trying to focus on traffic while your chest feels like it’s on fire.
The same goes for chronic constipation, abdominal pain, nausea, diarrhea, or gastrointestinal cramping. Those symptoms can pull your attention away from the road long before a medication ever does.
Many autistic people are already working hard to keep track of sensory overload, physical discomfort, and everything else going on around them. When your digestive system is demanding attention, that’s one more thing pulling your focus away from the road.
(If you’ve been following my work in any meaningful way, then you KNOW I have to mention that I don’t think meds should be the first thing you reach for gastrointestinal distress. Go back through Chapter 2 (specifically blog posts #10-11–12–13) to see how to appropriately support and resolve most GI problems WITHOUT resorting to suppressing the symptoms with meds.)
Because teens and adults on the autism spectrum are likely to be on psychiatric medications4 AND acid reflux medications, I have to mention that PPIs can interact with and sometimes increase blood levels—and therefore side effects—of certain psychiatric and neurological medications.5
Here’s a simple cheat sheet for the ones to look out for:5,6
Medication Class | The Specific Culprits |
|---|---|
Anxiety & Sleep Medications | Diazepam (Valium) and triazolam (Halcion) |
Selective Serotonin Reuptake Inhibitors (SSRIs) | Citalopram (Celexa) and escitalopram (Lexapro) |
Anticonvulsants / Mood Stabilizers | Phenytoin (Dilantin) |
These interactions are seen most often with omeprazole and esomeprazole. Pantoprazole generally has a much lower interaction potential.6
If you are taking a daily PPI alongside a psychiatric or neurological medication, it’s worth asking your prescriber whether any interactions are worth paying attention to. If the answer is yes, clinicians often swap the PPI for pantoprazole (Protonix) or an H2 blocker like famotidine (Pepcid), both of which pose significantly less risk of accidental behind-the-wheel sedation.
Avoid the panic moment during driving
Laxatives and bowel preparation products deserve special mention.
Not because they impair judgment.
Because they can make driving extremely inconvenient.
Anyone who has ever taken a strong stimulant laxative already knows where this conversation is headed.
The last place you want to discover that a medication has become active is halfway through a long drive with no restroom in sight.
Are you drinking enough water? If you’ve ever spent a day running back and forth to the bathroom after taking a laxative and forgotten to hydrate, you already know how wiped out you can feel afterward.
Anti-Diarrheal Medications and Other GI Treatments
Most anti-diarrheal medications aren’t a problem, but again, if you’re in the sensitive group you might notice fatigue, dizziness, or just feeling “off.”
Know Your Patterns
You’ve heard me say this several times already in this chapter: When do you take the medication? How do you feel afterward?
Do you notice fatigue, dizziness, headaches, increased bathroom urgency, or difficulty concentrating?
And if you notice something that concerns you, bring it up or switch to a different medication.
And for next time, I have to go there. Yes, there.
So many autistic families, teens and adults tell me that CBD, THC gummies, hemp extract, “pot”, marijuana ─ whatever you want to call it ─ helps them feel better and cope better, and can’t imagine a day without it. So we’re going to wrap up Chapter 3 by digging in and seeing what the consequences, both positive and negative, of cannabis might be for driving.
Want the Research?
- Gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. McElhanon, J. L., McCracken, C., Karpen, S., & Sharp, W. G. (2014). Pediatrics, 133(5), 872–883. https://doi.org/10.1542/peds.2013-3995
- Global prevalence of autism spectrum disorder and its gastrointestinal symptoms: A systematic review and meta-analysis Jingyi Wang, Bin Ma, Jingjing Wang, Zeyi Zhang, Ou Chen Front Psychiatry. 2022 Aug 23:13:963102. PMCID: PMC9445193
- Prevalence of gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. Lasheras I, Real-López M, Santabárbara J. An Pediatr (Engl Ed). 2023 Aug;99(2):102-110. doi: 10.1016/j.anpede.2023.07.003. Epub 2023 Jul 18. PMID: 37474417.
- Use of Psychotropic Drugs in Patients with Autism Spectrum Disorders: A Systematic Review. Jobski K, Höfer J, Hoffmann F, Bachmann C. Acta Psychiatr Scand. 2017.
- Effect of Proton Pump Inhibitors on the Serum Concentrations of the Selective Serotonin Reuptake Inhibitors Citalopram, Escitalopram, and Sertraline. Gjestad C, Westin AA, Skogvoll E, Spigset O. Ther Drug Monit. 2015;37(1):90–97.
- Pharmacokinetic drug interaction profile of omeprazole with adverse consequences and clinical risk management. Li W, Zeng S, Yu LS, Zhou Q. Ther Clin Risk Manag. 2013;9:259-71. doi: 10.2147/TCRM.S43151. Epub 2013 May 27. PMID: 23745048; PMCID: PMC3671798.