Aripiprazole and Autism Ranking:

Aripiprazole

Aripiprazole is a type of medication called an atypical antipsychotic. It is sold under a variety of brand names including Abilify and Aripiprex.

Aripiprazole is primarily used to treat some of the symptoms of schizophrenia and depression.
Aripiprazole is believed to work by changing the behaviour and characteristics of key neurotransmitters in the brain, in particular serotonin and dopamine.

Aripiprazole is sometimes used to help children and adolescents diagnosed with autistic disorder control behaviours such as aggression, temper tantrums, and frequent mood changes.

Please note

The National Institute of Health and Care Excellence (NICE, 2012 and 2013) suggests that antipsychotic medications such as aripiprazole 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 limited amount of high quality research evidence (six randomised controlled trials and one non-randomised controlled trial) and a reasonable amount of low quality research (17 single-case design studies with three or more participants) into the use of aripiprazole for children and young people on the autism spectrum.

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

There is a considerable amount of research to suggest that aripiprazole produces significant side effects in some children and young people on the autism spectrum. Those side effects may include weight gain, sedation, fatigue, vomiting, somnolence, and tremor.

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

These studies should

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

We believe that if you are considering using aripiprazole 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

Audience

Aripiprazole is licenced by the US Federal Drugs Administration to treat a variety of mental health problems in adults, teenagers and children.
It is also licenced to treat children 6 to 17 years of age who have autistic disorder with irritable behaviour such as aggression, temper tantrums, and frequent mood changes. In practice, it is sometimes used with older people on the autism spectrum.

According to the American Society of Health-System Pharmacists (2017)

"Aripiprazole is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age and older. It is also used alone or with other medications to treat episodes of mania or mixed episodes (symptoms of mania and depression that happen together) in adults, teenagers, and children 10 years of age and older with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Aripiprazole is also used with an antidepressant to treat depression when symptoms cannot be controlled by the antidepressant alone. Aripiprazole is also used to treat children 6 to 17 years of age who have autistic disorder (a developmental problem that causes difficulty communicating and interacting with others). Aripiprazole may help control irritable behavior such as aggression, temper tantrums, and frequent mood changes in these children."

Aims and Claims

Aims

According to Stigler et al (2009)

“Aripiprazole is hypothesized to function as an agonist or antagonist, depending on the receptor population and local concentrations of DA.”

In other words aripiprazole is a dopamine system stabiliser i.e. where dopamine levels are high it acts as an antagonist (reducing the levels of dopamine) and where dopamine levels are low it acts as an agonist (increasing the levels of dopamine).

Some people believe that aripiprazole can be used to change the levels of dopamine in the central nervous system of individuals on the autism spectrum. They believe that this will have beneficial effects, including a reduction in hyperactivity, aggression, and repetitive behaviours.

Claims

There have been various claims made for the use of aripiprazole as a treatment for people on the autism spectrum. For example,

Numerous authors (such as Blankenship et al, 2010; Douglas-Hall et al, 2011; and Farmer and Aman, 2011) have reported that aripiprazole is safe and effective in treating irritability (defined as tantrums, aggression, self-injurious behaviour, or a combination of these symptoms) in children and adolescents on the autism spectrum.
Ching and Pringsheim (2012) reported that some researchers have reported improvements in social interaction and stereotypic behaviours, alongside reductions in anxiety, depression, aggression, hyperactivity, irritability, mood fluctuations, obsessive behaviours, psychotic symptoms, self-injurious behaviour, tantrums and tics.

Key Features

Aripiprazole is a type of atypical antipsychotic sold under the brand names Abilify and Aripiprex.

Aripiprazole appears to function as a dopamine system stabiliser i.e. where dopamine levels are high it acts as an antagonist (reducing the levels of dopamine) and where dopamine levels are low it acts as an agonist (increasing the levels of dopamine).

Aripiprazole comes in a variety of forms including as a tablet, a solution (liquid), and an orally disintegrating tablet (tablet that dissolves quickly in the mouth).

Individuals are usually started on a low dose of aripiprazole which is gradually increased or decreased depending on how well the medication works and what side effects are experienced.

For the latest information on specific formulations please see BNF: Aripiprazole and BNF for Children: Aripiprazole

Cost and Time

Cost

The cost of using aripiprazole will depend on a number of factors including the supplier, the brand, the dosage, and the length and frequency of treatment. Newer antipsychotics such as aripiprazole are generally more expensive than older antipsychotics such as haloperidol or chlorpromazine.

In the UK medications such as aripiprazole are available free of charge to patients within the NHS. In other countries the costs may be covered by some insurance policies.

According to the BNF website accessed on 17 April 2018, the NHS indicative price for aripiprazole varies enormously depending on the brand and the dosage. For example, 28 5 mg tablets can cost £3.75, £8.00, £20.63 or even £96.04 depending on the brand.

Time

The amount of time required to administer aripiprazole will depend to a certain extent on how it is administered. Tablets and drops are normally taken daily and can be administered by a parent if necessary. Depot injections can be given every few weeks or months but should only be administered by an appropriately trained health care worker.

Suppliers and Availability

Aripiprazole is a powerful drug with many potential side effects and contraindications. For this reason it should only be obtained on prescription from either a psychiatrist, or from a GP on the advice / recommendation of a psychiatrist.

Risks and Safety

Hazards

According to the American Society of Health-System Pharmacists (2017) aripiprazole can cause the following side effects: headache; nervousness; dizziness, feeling unsteady, or having trouble keeping your balance; heartburn; constipation; diarrhea; stomach pain; weight gain; increased appetite; increased salivation; pain, especially in the arms, legs, or joints.

More seriously it can sometimes cause seizures; slow, fast, or irregular heartbeat; chest pain; changes in vision; unusual movements of your body or face that you cannot control; high fever; muscle stiffness; falling; confusion; sweating; rash; hives; itching; swelling of the eyes, face, mouth, lips, tongue, throat, hands, feet, ankles, or lower legs; difficulty breathing or swallowing; tightening of the neck muscles; tightness in the throat.

Even more seriously aripiprazole can cause significant side effects in some older adults with dementia and in some children, teenagers, and young adults with depression.
“Studies have shown that older adults with dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such as aripiprazole have an increased chance of death during treatment. Older adults with dementia may also have a greater chance of having a stroke or ministroke or other severe side effects during treatment.”

and

“A small number of children, teenagers, and young adults (up to 24 years of age) who took medications for depression during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take aripiprazole to treat depression, but in some cases, a doctor may decide that aripiprazole is the best medication to treat a child's condition.”

Contraindications

There are some contraindications (something which makes a particular treatment or procedure potentially inadvisable) for aripiprazole. For example, according to the American Society of Health-System Pharmacists (2017), aripiprazole should be used with caution in people who are allergic to aripiprazole; who are taking medications that may react with aripiprazole (such as some antidepressants); who are dehydrated; who have specific medical conditions (such as heart disease); who are pregnant or breastfeeding.
Please see American Society of Health-System Pharmacists (2017), for a full list of potential hazards and contraindications.

History

Aripiprazole was developed by the pharmaceutical company Otsuka in Japan, although it markets the drug jointly with the pharmaceutical company Bristol-Myers Squibb in some other countries.

It was approved by the US Food and Drug Administration (FDA) for the treatment of schizophrenia in 2002. It was approved for use in the treatment of bipolar disorder in 2004.
In 2009 the FDA approved aripiprazole for the treatment of irritability associated with autistic disorder in children aged 6 to 17 years.

According to NICE, antipsychotic drugs, such as aripiprazole, are now in common use to treat people on the autism spectrum.

‘Antipsychotic drugs have been widely used in people with autism; for instance, a longitudinal study of 286 adolescents and adults in the US found that they were the second most commonly taken drug among people aged over 20 years (38%), after antidepressants (44%) (Esbensen et al., 2009). In a UK audit of drug use for challenging behaviour in a learning disabilities sample (in which the commonest coexisting diagnosis was autism), 96% were prescribed antipsychotic medication (Marshall, 2004). In another community sample of people with a learning difficulty, Dhumad and Markar (2007) reported that autism was the reason for prescribing antipsychotic medication in 20% of people.’

Current Research

Description of the studies

We have identified 23* studies of aripiprazole as a treatment for people on the autism spectrum in peer-reviewed journals published in English.

These studies included more than 800 individuals on the autism spectrum aged from 4 years old to adult, although the bulk of studies were of children and young people. Individuals with specific diagnoses included people with autistic disorder, Asperger syndrome or pervasive developmental disorder - not otherwise specified. A small number of studies also included people with other conditions, such as bipolar disorder or Fragile X syndrome.

The length of treatment varied between eight weeks and two and a half years, although in most cases the treatment lasted eight,12 or 24 weeks. The dosage of aripiprazole varied from 0.5 mg to 30 mg per day, although in most case the dosage was in the region of 5mg, 10mg or 15 mg per day. Younger children received smaller doses than adolescents and adults. In most cases, the medication was started at a low dose and gradually increased to a higher maximum dose.

Seven of the studies used a group design, usually comparing a group of people receiving aripiprazole to a different group receiving a placebo. 16 of the studies used single case designs, usually in the form of an open trial of aripiprazole within a single group. A minority of the group studies compared aripiprazole with other antipsychotics, such as risperidone.

Seven of the papers reported data from the same two studies (Marcus et al, 2009 and Owen et al, 2009). For example, the paper by Robb et al (2011) provided information on the safety and tolerability of aripiprazole pooled from these two studies.

Two of the papers reported on the same study which compared antipsychotics combined with a parent training programme against antipsychotics alone. The bulk of participants who received an antipsychotic received risperidone rather than aripiprazole.

*Please note: we have not included studies with fewer than three autistic participants.

Outcomes of the studies

Most of the studies (such as Marcus et al, 2009 and Owen et al, 2009) reported reduced irritability (which includes tantrums, aggression, self-injurious behaviour, or a combination of these symptoms).

Two of the studies (Marcus et al, 2009 and Owen et al, 2009) also reported improvements in the quality of life of the participants and of their family members.

A number of studies reported improvements in other areas. For example

One study (Fung et al, 2012) reported that aripiprazole improved 'auditory processing, and modulation of visual input affecting emotional responses and activity level, suggesting that aripiprazole might be beneficial in targeting sensory abnormalities in autism.’
One study (Huang, Tsai and Yang, 2010) reported that aripiprazole “significantly improved the social interaction of ... three children. Furthermore, two patients also showed significant improvement in depression/anxiety syndromes.”

A minority of studies reported mixed findings. For example

Findling et al (2014) reported “In this study, there was no statistically significant difference between aripiprazole and placebo in time to relapse during maintenance therapy. However, the [hazard ratio] and [number needed to treat] suggest some patients will benefit from maintenance treatment.”
Rugino and Janvier Y (2005) reported “Only 4 of 16 bipolar and autistic subjects (25%) demonstrated reduced aggression without adverse events... Coadministration of sedative medications (particularly guanfacine or clonidine) and weight < 58 kg increased the risk of adverse events, such as increased lability and aggression.”

Some of the studies reported adverse effects. For example,

Marcus et al (2011) reported “Adverse events were experienced by 286/330 subjects (86.7%). Common adverse events included weight increase, vomiting, nasopharyngitis, increased appetite, pyrexia, upper respiratory tract infection, and insomnia.”

Some of the studies (such as Ishitobi et al, 2012) reported that aripiprazole was well tolerated by some participants and might constitute an alternative treatment for subjects on the autism spectrum who experience tolerability issues with risperidone.

Status Research

There are a number of limitations to all of the research studies published to date. For example

Type of study

Most of the studies (such as Jordan et al, 2012) used single-case designs, that is, they did not have a control group of participants who did not receive aripiprazole.
Most of the single case design studies used relatively weak methodologies. For example, Fung et al (2012) used a non-experimental, retrospective chart review.
One of the group studies (Lamberti et al, 2016) was a controlled study but it was non-randomised and non-blinded.
Some of the studies did not follow (or provide information about) all of the protocols expected within that type of study. For example, the randomised controlled trial by Marcus et al (2009) did not adequately describe the blinding process.

Participants

Some of the studies (such as Huang,Tsai and Yang, 2010) included fewer than 10 participants.
Some of the studies had a very high dropout rate. For example, in the study by Marcus et al (2011), only 199 of 330 participants (60.3%) completed 52 weeks of treatment.
Some of the studies were restricted to specific groups of participants. For example, Findling et al (2014) looked only at children and young people diagnosed with autistic disorder.
Some of the studies examined participants with a range of conditions, only some of whom were on the autism spectrum. For example, Valicenti-McDermott and Demb (2006) studied 32 participants with developmental disorders 24 of whom were on the autism spectrum.
Some of the studies (such as Rugino and Janvier, 2005) did not independently verify the diagnosis of autism using established diagnostic tools like the ADOS or ADI-R.

Intervention/s

Some of the studies gave very little detail about the aripiprazole and how it was administered. For example, Gibson et al (2007) did not state the length of treatment, the frequency of treatment or the dosage of aripiprazole that was given to the participants.
Two of the papers (Aman et al, 2009 and Scahill et al, 2012) reported on the same study which compared antipsychotics combined with a parent training programme against antipsychotics alone. However the bulk of participants who received an antipsychotic in this study received risperidone rather than aripiprazole.
Some of the studies (such as Rugino and Janvier, 2005) examined participants who received one or more other medications at the same time as they received aripiprazole.
Some of the studies (such as Ichikawa et al, 2017) ran for relatively short periods of time (eight weeks).

Outcomes

Some of the studies used a small number of outcome measures and/or used less robust outcome measures. For example, Basgul (2014) used only one outcome measure, the Clinical Global Impression Scale. This is less robust than some other measures because it relies on the subjective judgement of the clinician.
Some of the studies did not break down outcome data by specific groups of participants. For example, Erickson et al, 2011 examined 12 participants with Fragile X syndrome but did not provide separate outcome data for the 10 participants who were also on the autism spectrum.
Some of the studies (such as Huang et al, 2010) did not provide any kind of statistical analysis of the outcomes.
Some of the studies (such as Jordan et al, 2012) did not report objective measures of potential adverse side effects (such as changes to blood glucose levels etc.).
Most of the studies did not identify if aripiprazole had any beneficial effects in the medium to long term (six months or longer).

Other

Most of the studies did not appear to involve people on the autism spectrum or parents and carers in the design, development and evaluation of those studies.
Some of the studies (such as Marcus et al, 2009 and Owen et al, 2009) were funded by Otsuka and/or Bristol-Myers Squibb, the manufacturer and suppliers of aripiprazole. The researchers involved may therefore have been biased towards the intervention, however unconsciously.

For a comprehensive list of potential flaws in research studies, please see ‘Why some autism research studies are flawed’.

Ongoing Research

The Cambridge Health Alliance and Bristol-Myers Squibb are running one trial into the efficacy, safety and tolerability of aripiprazole in children with ASD. Clinical Trials Gov Ref: NCT00308074. For more details, please see An open-label trial of aripiprazole in autism spectrum disorders Full Item (Open in New Window).
Drexel University is running one trial into the use of aripiprazole. Clinical Trials Gov Ref: NCT00208533. For more details, please see Aripiprazole in children with autism: A pilot study Full Item (Open in New Window).
The National Institute of Mental Health is running a trial into the use of Aripiprazole. For more details, please see Evaluating the effectiveness of aripiprazole and D-cycloserine to treat symptoms associated with autism Clinical Trials Gov Ref: NCT00198107 Full Item (Open in New Window).
The University of Medicine and Dentistry New Jersey is running one trial into the use of aripiprazole. Clinical Trials Gov Ref: NCT00468130. For more details, please see Efficacy of aripiprazole versus placebo in the reduction of aggressive and aberrant behavior in autistic children Full Item (Open in New Window).

Future Research

Summary of Existing Research

There is a limited amount of high quality research evidence (nine controlled and randomised controlled trials) and a reasonable amount of low quality research (17 single-case design studies with three or more participants) into the use of aripiprazole for children and young people on the autism spectrum.

Recommendations for Future Research

There is a need for further, large-scale, randomised, double-blind trials on the effectiveness of aripiprazole. These studies should

Investigate the optimal dosage and length of treatment of aripiprazole for different individuals on the autism spectrum including adults.
Compare aripiprazole 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 in people on the autism spectrum.
Compare aripiprazole with other types of interventions (such as behavioural programmes) which are designed to reduce these type of irritable behaviours.
Investigate the use of combined, multi-component programmes which use aripiprazole alongside other types of interventions (such as parent training programmes).
Use objective measures to monitor any potential behavioural side effects (such as reduced irritability) and metabolic side effects (such as weight gain or changes in serum prolactin) over the longer term.
Include health-related quality of life as an outcome measure.
Involve people on the autism spectrum and parents and carers in the design, development and evaluation of those studies.
Be undertaken by researchers independent of the manufacturer and supplier of aripiprazole.

Studies and Trials

This section provides details of scientific studies into the effectiveness of aripiprazole for people on the autism spectrum which have been published in English-language, peer-reviewed journals.

If you know of any other publications we should list on this page please email info@informationautism.org

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Studies and Trials

Aman M. G. et al. (2009) Medication and parent training in children with pervasive developmental disorders and serious behavior problems: Results from a randomized clinical trial. Journal of the American Academy of Child and Adolescent Psychiatry. 48(12), Read Abstract (New Window) Read Full (New Window)
Aman M. G. et al. (2010) Line-item analysis of the Aberrant Behavior Checklist: results from two studies of aripiprazole in the treatment of irritability associated with autistic disorder. Journal of Child and Adolescent Psychopharmacology. 20(5), Read Abstract (New Window)
Basgul S. S. (2014) Aripiprazole use in children and adolescents: A public hospital child psychiatry outpatient department’s experience. Bulletin of Clinical Psychopharmacology. 24(1),
Erickson C. A. et al. (2011) A prospective open-label study of aripiprazole in fragile X syndrome. Psychopharmacology (Berl). 216(1), Read Abstract (New Window)
Findling R. L. et al. (2014) A randomized controlled trial investigating the safety and efficacy of aripiprazole in the long-term maintenance treatment of pediatric patients with irritability associated with autistic disorder. Journal of Clinical Psychiatry. 75(1), Read Abstract (New Window)
Fung L. K. et al. (2012) A retrospective review of the effectiveness of aripiprazole in the treatment of sensory abnormalities in autism. Journal of Child and Adolescent Psychopharmacology. 22(3), Read Abstract (New Window)
Ghanizadeh A., Sahraeizadeh A., Berk M. (2014) A head-to-head comparison of aripiprazole and risperidone for safety and treating autistic disorders, a randomized double blind clinical trial. Child Psychiatry and Human Development. 45(2), Read Abstract (New Window)
Gibson A. P. et al. (2007) Effectiveness and tolerability of aripiprazole in child and adolescent inpatients: a retrospective evaluation. International Clinical Psychopharmacology. 22(2), Read Abstract (New Window)
Hellings J. A. et al. (2011) Long-term aripiprazole in youth with developmental disabilities including autism. Journal of Mental Health Research in Intellectual Disabilities. 4(1), Read Abstract (New Window)
Huang S., Tsai S., Yang H. (2010) Aripiprazole improves social interaction in Taiwanese children with pervasive developmental disorder. Chang Gung Medical Journal. 33(2), Read Abstract (New Window) Read Full (New Window)
Ichikawa H. et al. Aripiprazole in the treatment of irritability in children and adolescents with autism spectrum disorder in Japan: A randomized, double-blind, placebo-controlled study. Child Psychiatry and Human Development. Read Abstract (New Window)
Ishitobi M. et al. (2012) Switching to aripiprazole in subjects with pervasive developmental disorders showing tolerability issues with risperidone. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 37(1), Read Abstract (New Window)
Ishitobi M. et al. (2013) Effectiveness and tolerability of switching to aripiprazole from risperidone in subjects with autism spectrum disorders: a prospective open-label study. Clinical Neuropharmacology. 36(5), Read Abstract (New Window)
Jordan I. et al. (2012) Aripiprazole in the treatment of challenging behaviour in adults with autism spectrum disorder. Psychopharmacology (Berl). 223(3), Read Abstract (New Window)
Kim Y. et al. (2010) Retrospective case series of aripiprazole augmentation in pervasive developmental disorders. Psychiatry Investigations. 7(3), Read Full (New Window)
Lamberti M. et al. (2016) Head-to-head comparison of aripiprazole and risperidone in the treatment of ADHD symptoms in children with autistic spectrum disorder and ADHD: A pilot, open-label, randomized controlled study. Pediatric Drugs. 18(4), Read Abstract (New Window)
Maloney A., Mick E., Frazier J. (2014) Aripiprazole decreases irritability in 12 out of 14 youth with autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology. 24(6), Read Abstract (New Window)
Mankoski R. et al. (2013) Aripiprazole treatment of irritability associated with autistic disorder and the relationship between prior antipsychotic exposure, adverse events, and weight change. Journal of Child and Adolescent Psychopharmacology. 23(8), Read Abstract (New Window)
Marcus R. N. et al. (2009) A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 48(11), Read Abstract (New Window)
Marcus R. N. et al. (2011) Aripiprazole in the treatment of irritability in pediatric patients (aged 6-17 years) with autistic disorder: results from a 52-week, open-label study. Journal of Child and Adolescent Psychopharmacology. 21(3), Read Abstract (New Window)
Marcus R. N. et al. (2011) Safety and tolerability of aripiprazole for irritability in pediatric patients with autistic disorder: a 52-week, open-label, multicenter study. Journal of Clinical Psychiatry. 72(9), Read Abstract (New Window)
Masi G. et al. (2009) Aripiprazole monotherapy in children and young adolescents with pervasive developmental disorders: a retrospective study. CNS Drugs. 23(6), Read Abstract (New Window)
Owen R. et al. (2009) Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. Pediatrics. 124(6), Read Abstract (New Window) Read Full (New Window)
Robb A. S. et al. (2011) Safety and tolerability of aripiprazole in the treatment of irritability associated with autistic disorder in pediatric subjects (6-17 years old):results from a pooled analysis of 2 studies. Primary Care Companion to CNS Disorders. 13(1), Read Abstract (New Window) Read Full (New Window)
Rugino T. A., Janvier Y. (2005) Aripiprazole in children and adolescents: clinical experience. 20(7), Read Abstract (New Window)
Scahill L. et al. (2012) Effects of risperidone and parent training on adaptive functioning in children with pervasive developmental disorders and serious behavioral problems. Journal of the American Academy of Child and Adolescent Psychiatry. 51(2), Read Abstract (New Window)
Stigler K. A., Posey D. J., McDougle C. J. (2004) Case report: aripiprazole for maladaptive behavior in pervasive developmental disorder. Journal of Child and Adolescent Psychopharmacology. 14(3), Read Abstract (New Window)
Stigler K. A. et al. (2009) Aripiprazole in pervasive developmental disorder not otherwise specified and Asperger's disorder: a 14-week, prospective, open-label study. Journal of Child and Adolescent Psychopharmacology. 19(3), Read Abstract (New Window) Read Full (New Window)
Valicenti-McDermott M. R., Demb H. D. (2006) Clinical effects and adverse reactions of off-label use of aripiprazole in children and adolescents with developmental disabilities. Journal of Child and Adolescent Psychopharmacology. 16(5), Read Abstract (New Window)
Varni J. W. et al. (2012) Effect of aripiprazole 2 to 15 mg/d on health-related quality of life in the treatment of irritability associated with autistic disorder in children: A post hoc analysis of two controlled trials. Clinical Therapeutics. 34(4), Read Abstract (New Window)

Additional Information

According to Hirsch and Pringsheim (2016),

“Evidence from this review shows that use of aripiprazole for the short-term treatment of irritability in children/adolescents with ASD may be worth considering. If the decision is made to use aripiprazole, clinicians should follow established best practice and provide information about side effects such as weight gain, tremor, drooling and sedation to children/adolescents and their families, so they can consider the benefits and risks of treatment before commencing a medication trial. Children/adolescents undergoing a trial of therapy with aripiprazole should be monitored for clinical effectiveness of the medication, as well as for side effects. In the absence of high-quality evidence, and given that similar relapse rates are observed for both aripiprazole and placebo, evidence suggests that the use of aripiprazole should be re-evaluated periodically for continued efficacy, and that it might be appropriate to consider discontinuation of aripiprazole after successful treatment for 12 weeks.”

Related Additional Information

Aripiprazole

Updated: 17 Jun 2022
Last Review: 01 Jul 2018
Next Review: 01 Mar 2024