Antipsychotic Use in Autistics

Someone in a support group for pathological demand avoidance (a form of autism that is mostly only recognized in the UK) asked about using Risperdal (risperidone) for aggression and anxieyt. This prompted me to write about my experiences of medication use, and I want to elaborate on them, particularly as I made an interesitng self-observation today.

There is a lot of controvery surroudning the use of medications, particularly antipsychotics, for autism spectrum disorders. I personally do not disagree with the use of antipsychotics. They have a relatively solid evidence base, especially Risperdal and Abilify (aripiprazole). I have used both myself and currently take Abilify in a fairly high dose.

I have pointed this out before, but I want to say it again: if there are other changes in treatment, placement or support happening near the time you’re wanting to start medication, that’s not a wise moment to start medication. I started Risperdal a week before my move into independent living, and, if it had any effect at all, this was annihilated by the effects of the move. Also, don’t expect antipsychotics to get someone through a rough time These drugs are designed for long-term use and usually take several weeks to kick in. Benzodiazepines are better in this case, but don’t expect medications to cure support needs. Autistic people will always need support.

Antipsychotics are commonly used for aggression and irritability, but I made this interesting self-observation that my Abiilify also seems to help with rigidity and the resulting asocial behavior. I remember a few years ago reading a case study on the use of Abilify for core symptosm of Asperger’s (I’m too lazy to look up the reference). This may pose its own ethical dilemmas, cause what do we want to change about a utistics (especially children or others who are incapacitated) and what falls within the realm of acceptable neurodivergence? I wont’go into this right now.

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