Aripiprazole for Autism-Related Behaviors: Parent/Patient Education Handout
What is Aripiprazole?
Aripiprazole (Abilify) is an FDA-approved medication specifically for treating irritability, aggression, tantrums, and self-injurious behaviors in children and adolescents aged 6-17 years with autism spectrum disorder. 1 This medication does not treat the core features of autism (social communication difficulties), but targets specific behavioral problems that can interfere with learning and daily functioning. 1
How Does It Help?
Aripiprazole has been proven effective in reducing:
- Irritability and tantrums - Studies show 56% of children respond positively compared to 35% on placebo 2
- Aggression toward others 3
- Self-injurious behaviors 3
- Hyperactivity and impulsivity 2
- Repetitive behaviors (stereotypy) 2
Dosing for Your 12-Year-Old
The starting dose is typically 2 mg per day, with gradual increases to a target dose of 5-15 mg daily based on response and tolerability. 3, 4
- Week 1-2: Usually start at 2 mg daily
- Week 3+: Increase gradually to 5,10, or 15 mg daily as needed 4
- Most common effective dose: 5-10 mg daily 5
- Maximum dose: 15 mg daily 4
The medication is taken once daily and can be given with or without food. 6
When Will You See Results?
Improvements typically begin within the first week of treatment and continue to increase over 8 weeks. 3, 4 However, some behavioral symptoms may still persist even with good response, so realistic expectations are important. 3
Common Side Effects to Monitor
Most Common (Watch for These):
- Weight gain - Expect 1-2 kg (2-4 pounds) in the first 8 weeks, with weight stabilizing at 3-6 months 6, 4
- Drowsiness/sedation - Usually mild to moderate and may improve over time 2, 3
- Increased appetite 6
Less Common but Important:
- Movement problems (tremor, restlessness, stiffness) - Occurs in about 15% of children 3
- Drooling 2
- Fatigue 2
- Vomiting 2
Serious Side Effects (Call Doctor Immediately):
- Severe drowsiness that doesn't improve
- Uncontrollable movements
- Significant behavioral worsening
- Allergic reactions
Important Monitoring Requirements
Your child will need regular monitoring including: 1
- Weight and height - Check every visit, especially first 6 months
- Blood pressure and heart rate - Baseline and periodic checks
- Blood tests - Metabolic panel (blood sugar, cholesterol) at baseline, 3 months, then yearly
- Movement assessment - Watch for any unusual movements or stiffness
Maximizing Success: Combining with Behavioral Therapy
Medication works best when combined with behavioral interventions and parent training. 1, 7 The combination is significantly more effective than medication alone for reducing serious behavioral problems. 1 Continue all educational and behavioral therapies while taking aripiprazole. 8
What If It Doesn't Work Well Enough?
If behavioral problems persist after 8 weeks at an adequate dose:
- Reassess for environmental triggers of behavior 1
- Ensure behavioral interventions are optimized 7
- Consider whether other psychiatric conditions (like ADHD) need separate treatment 7
- Discuss alternative medications with your doctor 1
Important Safety Information
- Do not stop suddenly - Always taper off gradually under doctor supervision
- Avoid overheating - Stay hydrated and avoid excessive heat exposure
- Drug interactions - Tell all doctors your child takes aripiprazole
- Long-term effects - The long-term effects in children are not fully known, so ongoing monitoring is essential 8
When to Call the Doctor
Contact your healthcare provider if you notice:
- Worsening aggression or new self-harm behaviors
- Extreme drowsiness interfering with daily activities
- Unusual movements (muscle stiffness, tremors, restlessness)
- Rapid weight gain (>2 kg per month after initial period)
- High fever with muscle rigidity (rare but serious)
Realistic Expectations
Most children show meaningful improvement in irritability and aggression, but complete elimination of all challenging behaviors is uncommon. 3 The goal is to reduce behaviors enough that your child can better participate in school, therapy, and family activities. 8 Approximately 50-70% of children have a positive response to treatment. 2, 4
Duration of Treatment
Treatment duration varies by individual response. Many children continue medication for months to years if it remains effective and well-tolerated. 6 Regular reassessment every 3-6 months helps determine if continued treatment is beneficial. 1