There is no cure for autism spectrum disorder, but medications might help improve some behaviors related to the condition, such as hyperactivity and aggression.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder, meaning it can affect the way a person behaves, interacts, and communicates.

Autism exists on a spectrum, and there’s a wide range of support needs within that spectrum. The level of support needed varies from person to person. No two autistic people are alike.

So, clinicians will work with you to determine the level of your individual needs. This will help them develop the right management plan for you.

There is no single best way to manage autism. Services typically include behavioral therapies and educational programs. In some cases, medication might be used to help manage certain conditions that often occur alongside autism.

But medications are not intended to act as a “cure” for autism. If you or your child are prescribed medication, consider monitoring for behavior changes and side effects, and track progress. If you see anything concerning, reach out to your healthcare or mental health professional.

Medication for autism is a complicated and controversial topic.

Researchers estimate that more than 50% of autistic children and adolescents are prescribed medications to help manage autism-related behaviors or co-occurring conditions.

A 2013 study showed that 64% percent of autistic children were prescribed at least one psychiatric medication, and 35% percent were taking more than one. Autistic adults may be more likely to take more than one medication.

There is no medication for autism itself or for its core symptoms, which are usually classified into three categories:

  • difficulties with social interactions
  • trouble communicating
  • repetitive behaviors

Medication may, however, be used to manage behaviors or conditions that tend to co-occur with autism.

A class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat depression. They work by changing your levels of serotonin — a neurotransmitter in the brain believed to be responsible for stabilizing your mood.

Research indicates that SSRIs might help reduce the intensity and frequency of these autism-related behaviors:

  • repetitive actions
  • anxiety
  • irritability
  • tantrums
  • aggressive actions

SSRIs that might be prescribed include:

The SSRIs most commonly prescribed to autistic people are fluoxetine and sertraline.

Sertraline is often the top choice because its side effects are milder than those of other SSRIs and because it has fewer interactions with other drugs. Also, it has been approved by the FDA for treatment of obsessive-compulsive disorder (OCD) in children, though not for autism.

However, two other more recent studies — one in 2019 and another in 2020 — show that SSRIs, particularly fluoxetine (Prozac), do not improve repetitive behaviors in autistic children and adolescents. These findings echo results from earlier research.

Yet, these medications remain widely prescribed because they sometimes help manage symptoms of conditions that co-occur with autism, like anxiety and depression. In fact, according to a 2019 clinical trial, approximately 21% to 32% of autistic children and adolescents are prescribed SSRIs.

SSRIs can have significant side effects, such as:

  • agitation
  • anxiety
  • diarrhea or constipation
  • weight change
  • dizziness
  • dry mouth

Parents and caregivers of autistic children are often concerned that the long-term effects of SSRIs have yet to be fully determined. The FDA continues to require black box warnings on SSRI labels advising of an increased risk of suicidal ideation and behavior in teens and young adults. This warning has been in effect since 2004.

Tricyclic antidepressants are the oldest of the antidepressants, dating back to the 1960s. They work by reducing the reuptake, or absorption, of two neurotransmitters — norepinephrine (also called noradrenaline) and serotonin.

This increases availability of these neurotransmitters in the central nervous system, which is believed to help improve behaviors such as:

  • irritability
  • hyperactivity
  • inappropriate speech

Common tricyclics used include:

Tricyclic medications are less commonly used because they tend to cause more severe side effects than SSRIs.

You may also have a higher chance of overdosing with tricyclics than other antidepressants. Taking even a small amount over your normal dose can lead to an overdose.

The most common side effects of tricyclics are:

  • weight gain
  • drowsiness
  • dizziness
  • dry mouth
  • constipation
  • urinary retention (when your bladder doesn’t feel empty)
  • confusion
  • blurred vision or dry eyes

The atypical antipsychotics risperidone (Risperdal) and aripiprazole (Abilify) are the only two medications approved by the FDA to help reduce irritability in autistic children and teens.

This category of newer drugs has different side effects than the original antipsychotics. Antipsychotic medications are thought to work by affecting dopamine, a neurotransmitter in your brain associated with pleasure and reward. Dopamine is also believed to contribute to mood and decision-making.

Other atypical antipsychotics sometimes prescribed are:

Two older antipsychotics sometimes used include:

Common side effects associated with atypical antipsychotics include:

  • sleepiness
  • weight gain
  • trouble with movement
  • tremors

Stimulants are often prescribed for attention deficit hyperactivity disorder (ADHD). It’s common for autistic children to also have ADHD, or some of the same symptoms — such as hyperactivity, inattention, and impulsivity.

Methylphenidate (Ritalin) is the stimulant most commonly prescribed to autistic children with ADHD.

Other stimulants that might be used include:

  • amphetamine mixed salts (Adderall, Adderall XR)
  • methylphenidate XR (Concerta, Metadate CD)
  • dextroamphetamine (Dexedrine)
  • dexmethylphenidate (Focalin)

However, research on whether stimulants are in fact helpful in autistic children with ADHD is mixed. While some studies say that it’s effective and children are able to tolerate this medication, others state the opposite.

The challenge with stimulants is finding a medication with side effects that the child can tolerate. In some cases, stimulants can cause behaviors to worsen, possibly leading to aggressiveness or violent meltdowns.

Anxiety is a common co-occurring condition in autistic people. Some research suggests that around 50% of autistic adults and children live with anxiety. If you have autism, you might experience:

Managing anxiety in autistic children and adults is complicated. Sometimes, the same symptoms occur in both autism and anxiety disorders, so it’s difficult to know which one came first. Are the autism-related behaviors causing the anxiety, or is the anxiety causing the autism-type behaviors?

Also, research into anxiety treatments for autistic children and adults is minimal and often contradictory.

According to the National Institutes of Mental Health, the three main medications for anxiety are:

  • antidepressants
  • anti-anxiety medications
  • beta-blockers

Research is mixed about whether these work for anxiety in autistic people. One study recommends that anti-anxiety medication be used only after behavioral interventions have not helped. Also, correcting problematic situations like bullying at school might help improve the anxiety.

The researchers suggest the following medications might be tried, but with caution and careful medical supervision, as some of them carry a black box warning from the FDA regarding their use in children:

Each medication carries its own side effects, but some common ones include:

  • dizziness
  • drowsiness
  • headache
  • nausea and vomiting
  • dry mouth
  • constipation or upset stomach

Anti-seizure medications are sometimes used to treat other medical conditions co-occurring with autism, like seizure disorders.

Epilepsy, a seizure disorder, is common in autistic people. Research suggests that epilepsy occurs in about 12% of autistic people.

Common anti-seizure medications used are:

The common side effects of anti-seizure medications include:

  • weight gain
  • stomach problems
  • headache
  • fatigue or drowsiness
  • aggression
  • agitation

Finding the right medication for your child can be challenging. Giving medicine to an autistic child is never an easy choice. You might worry that the medication will somehow change your child into someone you don’t know, or that the side effects will be too much for them.

You may even wonder if medication is needed at all.

You might start out by asking your doctor — or your child’s doctor — whether medication is even an option.

Remember: Medications don’t cure autism. They can, however, treat symptoms or behaviors associated with autism.

If a doctor has recommended that you or your child take medication, here are some questions to consider asking:

  • Why are you recommending medication?
  • What can I expect the medication to do?
  • What side effects I should watch out for?
  • Who do I contact if my child has problems or I have concerns?
  • Are there any foods or medicines that will affect this medication?
  • How often will we come back for follow-up visits? Who will we see?
  • Will insurance cover this? How much will it cost?

Once your child has started medication, unwanted side effects may arise, like increased irritability or agitation. Also, symptoms may remain even after starting the medication.

A regimen of polypharmacy — taking several medications to manage one condition — might be started.

If you or your child are experiencing side effects, a second drug may be prescribed to help manage them. A separate drug might also be suggested for each individual symptom.

For example, a stimulant might be given for inattention, an SSRI for depression or anxiety, and an antipsychotic for aggression.

Polypharmacy can be useful, but it can sometimes cause adverse drug interactions. Be aware of each medication being prescribed, and why. Make sure both you and all your caregivers know the potential side effects or drug interactions to watch out for.

Whether you’re the caregiver of an autistic child or an autistic adult, you’re not alone. There are many social services, community education programs, and other resources available to help you.

Here are some tips for finding the services you need:

  • Your doctor, local health department, or school can provide information about special programs or resources. You can find resources near you through the Autism Society.
  • Your local chapter of the National Autism Association can also provide help and resources.
  • If you need help with employment and career issues, you can visit the U.S. Department of Labor autism resource list.
  • You can find an autism support group where you can share information and learn about treatment options and programs.
  • During meetings with school staff and medical professionals, consider taking detailed notes. These will help you make decisions about treatment along the way.
  • It’s a good idea to keep any copies of medical reports or evaluations. These will be helpful when you apply for special programs.