Related Experiment Video
Updated: Oct 5, 2025
An Electrophysiology Protocol to Measure Reward Anticipation and Processing in Children
Published on: October 4, 2018
Risperidone and aripiprazole for autism spectrum disorder in children: an overview of systematic reviews
Cecilia Fieiras1, Michael Hao Chen2, Camila Micaela Escobar Liquitay3
1School of Medicine, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Insights
Risperidone and aripiprazole effectively reduce autism spectrum disorder (ASD) symptoms in children short-term. However, these medications may cause adverse events, necessitating further research with longer follow-up periods.
Area of Science:
- Neuroscience
- Pediatric Psychiatry
- Pharmacology
Background:
- Autism spectrum disorder (ASD) is a complex neurodevelopmental condition.
- Behavioral and psychological symptoms associated with ASD often require pharmacological intervention.
- Risperidone and aripiprazole are atypical antipsychotics commonly used off-label for ASD symptoms.
Purpose of the Study:
- To systematically evaluate the efficacy and safety of risperidone and aripiprazole in children with ASD.
- To synthesize evidence from existing systematic reviews (SRs) on these medications for ASD.
Main Methods:
- An overview of systematic reviews (SRs) was conducted.
- Searches were performed across multiple databases (Cochrane, MEDLINE, Embase, PsycInfo, Epistemonikos) in October 2021.
- Included SRs were assessed for methodological quality using AMSTAR 2; evidence certainty was reported using GRADE.
Main Results:
- Both aripiprazole and risperidone demonstrated effectiveness in reducing core and non-core ASD symptoms, including irritability, repetitive behaviors, and social withdrawal, compared to placebo.
- The certainty of evidence for most outcomes was moderate.
- Adverse events, particularly metabolic and neurological, were associated with both medications, and follow-up periods in the reviewed studies were short.
Conclusions:
- Aripiprazole and risperidone likely offer short-term benefits for reducing symptom severity in children with ASD.
- Potential adverse events associated with these medications require careful consideration.
- There is a need for high-quality, updated SRs and larger, long-term randomized controlled trials to further elucidate the risk-benefit profile.
Objectives:
To assess the effectiveness and safety of risperidone and aripiprazole in children with autism spectrum disorder (ASD).
Design And Setting:
Overview of systematic reviews (SRs).
Search Methods:
In October 2021, we searched Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycInfo and Epistemonikos placing no restrictions on language or date of publication.
Participants:
Children aged 12 years or less with ASD.
Interventions:
Risperidone and aripiprazole with no dosage restrictions.
Data Collection And Analysis:
We rated the methodological quality of the included SRs using A Measurement Tool to Assess Systematic Reviews (AMSTAR 2). We reported the Grading of Recommendations, Assessment, Development and Evaluation certainty of the evidence according to the analysis conducted by the authors of the included SRs.
Main Outcomes Measured:
A multidisciplinary group of experts agreed on analysing nine critical outcomes evolving core and non-core ASD symptoms.
Patient And Public Involvement:
Organisations of parents of children with ASD were involved during part of the process, participating in external revision of the final version of the report for the Chilean Ministry of Health with no additional comments (ID 757-22-L120 DIPRECE, Ministry of Health, Chile). The organisations involved were: Fundación Unión Autismo y Neurodiversidad, Federación Nacional de Autismo, Vocería Autismo del Sur, and Vocería Autismo del Norte.
Results:
We identified 22 SRs within the scope of this overview, of which 16 were of critically low confidence according to AMSTAR 2 and were excluded from the analysis. Both aripiprazole and risperidone were effective for reducing autism symptoms severity, repetitive behaviours, inappropriate language, social withdrawal and behavioural problems compared with placebo. The certainty of the evidence for most outcomes was moderate. Risperidone and aripiprazole are associated with metabolic and neurological adverse events. Follow-up was short termed.
Conclusions:
We found that aripiprazole and risperidone probably reduce symptom severity at short-term follow-up but may also cause adverse events. High-quality and updated SRs and larger randomised controlled trials with longer term follow-up are needed on this topic.
Overview Protocol:
PROSPERO CRD42020206535.
Related Concept Videos
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
01:28Psychosis and Antipsychotic Drugs: Overview
01:26Psychosis: Goals of Pharmacotherapy
01:28Drug Therapy
Antianxiety Medications
01:21Antipsychotic Drugs: Typical and Atypical Agents
01:26Modeling in Therapy
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in...