Which two second-generation antipsychotics may be used in children with autism?

The use of second-generation antipsychotics in children with autism primarily involves addressing symptoms such as irritability, aggression, and mood dysregulation. Aripiprazole (Abilify) and Risperidone (Risperdal) have been extensively studied and are FDA-approved for the treatment of irritability associated with autism spectrum disorder in children.

Risperidone is effective in reducing irritability and has a well-established safety profile for pediatric use. Similarly, aripiprazole has also shown efficacy in managing behaviors associated with autism and is noted for a relatively lower risk of sedation and metabolic side effects compared to some other antipsychotic medications.

In contrast, other choices include medications that are not typically first-line options for autism-related symptoms or are not FDA-approved for use in children with autism. For instance, Clozapine is generally reserved for treatment-resistant schizophrenia and has significant side effects that make it less suitable for this population. Olanzapine is associated with substantial weight gain and metabolic syndrome risk, leading to its reduced use in pediatric settings.

Quetiapine and Ziprasidone also do not have the same level of evidence supporting their use for irritability in the context of autism, nor are they commonly indicated