Medication may be a treatment option for families who need additional support for behavioral and psychiatric conditions that may or may not be related to an autism diagnosis. This is often referred to as a “comorbid diagnosis” by medical providers and psychiatrists. Medications may be prescribed to address a variety of symptoms and conditions such as behavioral concerns (e.g., aggression and self-injury), impulsivity, anxiety, inattention, hyperactivity, and depression. In this article, we discuss how medications are typically prescribed and strategies for talking to your child’s provider and monitoring medication effects. 

Medications can be a useful treatment option to help address symptoms and behaviors related to autism. Understanding how medications are typically prescribed can help you make a more informed decision on whether medication is right for your child. For medication to be prescribed, it must first be thoroughly tested in clinical trials for the intended population and approved by the US Food and Drug Administration (FDA). Providers then use the treatment guidelines outlined by the FDA to identify potential medication options for their patients. 

Unfortunately, there aren’t many clinical trials conducted with autistic individuals, so it is rare for the FDA to approve medications specifically for autistic children. To date, the FDA has only approved two medications for autistic children and adults, specifically to treat irritability: Risperdal (risperidone) and Abilify (aripiprazole). Irritability may be displayed in relation to challenging behaviors such as self-injury, aggression (verbal and physical), tantrums or other outbursts. This doesn’t mean that irritability is the only symptom related to autism that you can use medication to treat. Other symptoms can be targeted using medications that are prescribed “off label” (i.e., not tested for specific populations by the FDA). This does not mean that no research has been done evaluating the effects these medications. It just means that there isn’t enough research to get FDA approval specifically for autistic people. For these medications, providers rely on FDA guidelines for non-autistic children to inform their treatment decision. For example, anti-depressants are FDA approved to treat obsessive-compulsive disorder in children but can also be helpful for repetitive behavior in autistic children. Providers can use prescription guidelines for children with obsessive-compulsive disorder to determine a course of treatment for autistic children with repetitive behavior. Below are some examples of the types of medications that are often used with autistic people. 

Class of Medication What is it used for? Example of Medications
Antidepressants Depressive symptoms, Repetitive behavior, Anxiety Prozac®, Zoloft®, Lexipro®, Celexa®, Luvox®, and Anafranil®
Antipsychotics Aggression and Self-injury Risperdal®, Zyprexa®, Seroquel®, Abilify®, and Geodon®.
Anticonvulsant Seizure disordersMood stabilizer Depakote®, Tegretol®, Lamictal®, Neurontin®, and Topamax®
Benzodiazepines Anxiety symptoms Ativan®, Xanax ® and Klonopin®
Beta Blockers and Alpha Agonists High blood pressure and anxiety Inderal®, Kapvay, and Catapres®
Stimulants Hyperactivity and Inattentiveness Ritalin®, Concerta®, and Adderall®

Working with your provider

Before deciding if medications are the right choice for your child, it is important that you have a thorough discussion about the medication with your child’s provider so you can make an informed decision about the risks and benefits of the medication. Here are some potential questions to ask your child’s provider about the medication they would like to prescribe (or are currently prescribing) (see Schall, 2002 for additional ideas):

     

      • Why are you recommending this particular medication for my child? What changes in their behavior do you expect us to see?

      • Has this medication been tested for use in autistic children? 

      • What symptom or behavior changes can we expect if the medication works?

      • How long does it typically take to see a change in behavior once starting the medication?

      • What side effects are common with this medication and what should I do if I see any of them?

      • What information should we collect at home and at school to help determine if the medication is working or not?

    When starting a new medication, it is crucial to monitor any changes in symptoms or behavior that may be due to the medication (Zarcone, Napolitano, & Valdovinos, 2008). This can help you determine if the medication benefits outweigh any risks (Schall, 2002). This is also important to assess if there is a change in the medication dose or a medication is stopped or discontinued. There are several ways that you can monitor the effect of medication, in collaboration with your provider, to determine if it is working or not. During follow-up visits, your child’s provider will likely ask you about any symptom or behavior changes you have noticed since starting the medication and this is an opportunity to share any data you or others have collected regarding behavior changes (e.g., your child’s teacher). 

    Changes in behavior

    When your child is taking medication, you should keep track of any changes you notice in their behavior. This can be used to determine if the medication is working the way it was intended to work. There are many ways you can keep track of behavioral changes. For example, you can use a weekly or daily data sheet to track the frequency of behavior the medication is prescribed to treat. See the links at the end of the article for examples of possible data sheets. You can also keep a journal log of any symptom changes or using a symptom tracking application on your smartphone (e.g., Best Behavior, BehaviorSnap). You can use a single data collection method or combine multiple methods. For example, you can use data sheets to monitor behavior while you are at home and take notes on your phone when you are in the community. If your child attends school or therapy, it may also be helpful to have teachers or clinicians monitor behavior changes. Before follow-up appointments with your child’s provider, you can have other service providers write notes or summaries of behavior changes they observed to share with the prescribing provider.

    Make sure that the medication prescribed for your child is having the intended effects on their behavior. Gathering information, like data on the targeted behavior, will allow you and your doctor to make informed decisions about how well it is working.

    Physiological changes and side effects

    Your child’s provider will want to monitor any side effects or adverse drug reactions. A side effect refers to any unintended effect of the medication that occurs at normal doses (Kalachink, 1999). This effect may not necessarily be harmful or beneficial, it is just not the intended effect of the medication. For example, a common side effect of Risperdal is increased appetite and hunger (Siegel & Erikson, 2016). An adverse drug reaction (or “adverse effects”) on the other hand, refers to uncharacteristic or unexpected reactions to the medication (Kalachink, 1990). These refer to allergic or toxic reactions due to the medication itself or an interaction between this medication and another medication or therapy. 

    Once you have a list of potential side effects, it may be helpful to make a chart or checklist to monitor them. This can help you identify if your child is experiencing side effects and the frequency with which they occur to share with your child’s provider. See the supplemental information for examples.  

    Your child’s provider may use rating scales to measure the presence and severity of side effects and adverse drug reactions. These rating scales can be comprehensive (measuring multiple potential side effects for many medications) or specific to a medication or side effect. Your child’s provider may also want to monitor any physiological changes using various lab tests or measures depending on the information they are trying to gather and the type of medication prescribed. With some medications, providers can measure the amount of active medication in your child’s body using a blood sample. This can help the provider understand how well your child’s body is absorbing and metabolizing the medication. This information can be used to ensure the correct dose of medication is prescribed. However, it is not necessarily helpful at determining if the medication is working or not without also looking at the behavioral data you have been collecting.  It’s important to understand that many medications have side effects, so get informed about what to look for and how to monitor them. Take these side effects into account when weighing the risks and benefits of taking a specific medication.

    Medications can be a beneficial treatment component for autistic children. While they do not address the core symptoms of autism, they can be used to treat related symptoms and conditions such as anxiety and irritability. When considering medication for your child, it is important to have a thorough discussion with your child’s provider about the potential risks and benefits of the medications. We hope that the information and suggestions provided in this article will help you prepare for discussions with your child’s provider as well as provide you with tools to monitor your child’s symptoms and behaviors if medication is prescribed. 

    Author’s note: portions of this article were previously published in:

    Morlino, R. M. & Zarcone, J. R. (2025). Medications prescribed for autistic children. Profound Autism: A Parent’s Guide. National Autism Center.

    References and Suggested Readings

    Dove, D., Warren, Z., McPheeters, M. L., Taylor, J. L., Sathe, N. A., & Veenstra-VanderWeele, J. (2012). Medications for adolescents and young adults with autism spectrum disorders: a systematic review. Pediatrics, 130(4), 717-726.

    Feroe, A. G., Uppal, N., Gutiérrez-Sacristán, A., Mousavi, S., Greenspun, P., Surati, R., … & Avillach, P. (2021). Medication use in the management of comorbidities among individuals with autism spectrum disorder from a large nationwide insurance database. JAMA pediatrics, 175(9), 957-965.

    Hirota, T., Veenstra-VanderWeele, J., Hollander, E., & Kishi, T. (2014). Antiepileptic medications in autism spectrum disorder: a systematic review and meta-analysis. Journal of autism and developmental disorders, 44(4), 948-957.

    Kalachnik, J. E. (1999). Measuring side effects of psychopharmacologic medication in individuals with mental retardation and developmental disabilities. Developmental Disabilities Research Reviews, 5(4), 348-359. 

    Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448.

    Schall, C. (2002). A consumer’s guide to monitoring psychotropic medication for individuals with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 17(4), 229-225. https://doi.org/10.1177/10883576020170040501

    Siegel, M. & Erickson, C. (2016). Autism spectrum disorder parents’ medication guide. American Academy of Child & Adolescent Psychiatry, American Psychiatric Association. https://www.aacap.org/App_Themes/AACAP/Docs/resource_centers/autism/Autism_Spectrum_Disorder_Parents_Medication_Guide.pdf

    Zarcone, J. R., Napolitano, D., & Valdovinos, M. G. (2008). Measurement of problem behaviour during medication evaluations. Journal of Intellectual Disabilities Research, 52, 1015-1028. https://doi.org/10.1111/j.1365-2788.2008.01109.x