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Aripiprazole and Autism Ranking: Mildly Hazardous Very strong positive evidence

Aripiprazole

Aripiprazole is a type of medication called an atypical antipsychotic. It is sold under a variety of brand names including Abilify and Aripiprex.

Aripiprazole is primarily used to treat some of the symptoms of schizophrenia and depression.
Aripiprazole is believed to work by changing the behaviour and characteristics of key neurotransmitters in the brain, in particular serotonin and dopamine.


Aripiprazole is sometimes used to help children and adolescents diagnosed with autistic disorder control behaviours such as aggression, temper tantrums, and frequent mood changes.

Please note

The National Institute of Health and Care Excellence (NICE, 2012 and 2013) suggests that antipsychotic medications such as aripiprazole can be used for managing challenging behaviour in children, young people and adults on the autism spectrum. However it recommends that antipsychotics should only be used after psychosocial or other interventions have been shown to be insufficient or could not be delivered because of the severity of the behaviour. If antipsychotics are used, they should only be used under very strictly controlled conditions and under the supervision of a paediatrician or psychiatrist.

Our Opinion

There is a limited amount of high quality research evidence (six randomised controlled trials and one non-randomised controlled trial) and a reasonable amount of low quality research (17 single-case design studies with three or more participants) into the use of aripiprazole for children and young people on the autism spectrum.

This research suggests that aripiprazole may be beneficial for the treatment of behaviours such as aggression, self-injurious behaviours and sudden mood changes in some children and young people on the autism spectrum. 

There is insufficient evidence to determine if aripiprazole provides any benefits in other areas (such as social communication and social interaction) to children and adolescents on the autism spectrum. There is insufficient evidence to determine if aripiprazole provides any benefits to adults on the autism spectrum.

There is a considerable amount of research to suggest that aripiprazole produces significant side effects in some children and young people on the autism spectrum. Those side effects may include weight gain, sedation, fatigue, vomiting, somnolence, and tremor.

There is a need for further, large-scale, randomised, double-blind trials on the effectiveness of aripiprazole.  

These studies should

  • Investigate the optimal dosage and length of treatment of aripiprazole for different individuals on the autism spectrum including adults.
  • Compare aripiprazole with other medications which are designed to achieve the same effects, that is, reduce behaviours such as aggression, self-injurious behaviours and sudden mood changes.
  • Compare aripiprazole with other types of interventions (such as behavioural programmes) which are designed to reduce these kind of behaviours. 
  • Investigate the use of combined, multi-component programmes which use aripiprazole alongside other types of interventions (such as parent training programmes). 
  • Use objective measures to monitor any potential behavioural and metabolic side effects over the longer term.

We believe that if you are considering using aripiprazole or any other type of antipsychotic medication, you should follow the guidance published by The National Institute of Health and Care Excellence (NICE, 2012 and 2013). 

Disclaimer

Please read our Disclaimer on Autism Interventions


Updated
03 Aug 2018
Last Review
01 Jul 2018
Next Review
01 Jul 2021