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Risperidone and Autism Ranking: Mildly Hazardous Very strong positive evidence

Anti-psychotic, risperidone

Risperidone is a type of medication called an atypical antipsychotic. It is sold under a variety of brand names including Belivon, Rispen and Risperdal.

Risperidone is primarily used to treat some of the symptoms of schizophrenia, bipolar disorder and other mental health problems.

Risperidone is believed to work by changing the behaviour and characteristics of key neurotransmitters in the brain, in particular dopamine.

Risperidone is sometimes used to help children and adolescents who have been diagnosed with autistic disorder control behaviours such as aggression, self-injurious behaviours and sudden mood changes. 

Please note

The National Institute of Health and Care Excellence (NICE, 2012 and 2013) suggests that antipsychotic medications such as risperidone 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 considerable amount of high quality research evidence (more than 20 controlled and randomised controlled trials) and a considerable amount of low quality research (more than 20 single-case design studies with three or more participants) into the use of risperidone for children and young people on the autism spectrum.

This research suggests that risperidone 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 risperidone 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 risperidone provides any benefits to adults on the autism spectrum.

There is a considerable amount of research evidence of significant side effects of risperidone in some children and young people on the autism spectrum. Those side effects may include weight gain, drowsiness and raised serum prolactin levels.  

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

These studies should

  • Investigate the optimal dosage and length of treatment of risperidone for different individuals on the autism spectrum including adults.
  • Compare risperidone 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 risperidone 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 risperidone 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.

If you are considering using risperidone 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