Autism Spectrum Disorder Drug Summary

Drug	Dosage	Remarks
Atypical/Second Generation Antipsychotics
Aripiprazole	6-17 years old: Initial dose: 2 mg PO 24 hourly May increase to 5 mg/day; if needed, may increase further to 10-15 mg/day Adjust dose with 5-mg increment at interval of >1 week	Adverse Reactions CNS effects (headache, anxiety, somnolence or insomnia); rare reports of tardive dyskinesia and neuroleptic malignant syndrome May cause orthostatic hypotension, seizure, dysphagia, or suicidal ideation Hyperglycemia may occur and in some cases be extreme, resulting in ketoacidosis, hyperosmolar coma, or death Special Instructions Use with caution in patients with seizure disorders, in suicidal patients, and those with concomitant illness Monitor growth, including weight, height and BMI to check for metabolic effects of Aripiprazole
Risperidone	Children ≥5 years old and adolescents <20 kg Initial dose: 0.25 mg/day PO 24 hourly or divided 12 hourly May increase to 0.5 mg/day after 4 days; maintain dose for 14 days If insufficient response, may increase by 0.25 mg/day in ≥2-week intervals Max dose: 1 mg/day ≥20 kg Initial dose: 0.5 mg/day PO 24 hourly or divided 12 hourly May increase to 1 mg/day after 4 days; maintain dose for 14 days If insufficient response, may increase by 0.5 mg/day in ≥2-week intervals Max dose: 2.5 mg/day	Adverse Reactions Generally well-tolerated Common reactions: CNS effects (insomnia, agitation, anxiety, headache, sedation more common in children than adults, mild and transient extrapyramidal symptoms) Less common reactions: CNS effects, less common (somnolence, fatigue, dizziness, impaired concentration, orthostatic hypotension); GI effects (constipation, dyspepsia, nausea/vomiting, abdominal pain); GU effects (priapism, erectile, ejaculatory and orgasmic dysfunction, urinary incontinence); Other effects (blurred vision, rhinitis, rash, allergic reactions, weight gain) Special Instructions Contraindicated in patients with hypersensitivity to Risperidone or any component of its formulation For children with weight <15 kg, use Risperidone with caution Use with caution in patients with decreased GI motility, GU and visual problems, increased risk of pneumonia, diabetes mellitus Caution patient about performing tasks requiring alertness
Conventional/First Generation/Typical Antipsychotic
Chlorpromazine	>6 months old: 0.55 mg/kg PO 4-6 hourly or IM 6-8 hourly	Adverse Reactions Neuromuscular effects (dyskinesia, dystonia, tremor); CV effects (postural hypotension, cardiac arrhythmias); Other effects (xerostomia, insomnia, blocked nose, agitation, leukopenia, respiratory depression) Special Instructions Contraindicated in patients with pre-existing CNS depression, coma, bone-marrow suppression, pheochromocytoma Use with caution in patients with liver or renal dysfunction, epilepsy, Parkinson’s disease, hypothyroidism, cardiac failure, history of narrow-angle glaucoma, myasthenia gravis, prostate hypertrophy

All dosage recommendations are for children with normal renal and hepatic function unless otherwise stated. 
Not all products are available or approved for above use in all countries. 
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs. 
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.