Systematic review of the effectiveness of pharmacological treatments for adolescents and adults with autism spectrum disorder.

Marita and her team hunted for every drug trial done with teens or adults who have autism.

They only kept studies that randomly gave either real medicine or placebo and lasted at least a few weeks.

In the end they found just five trials, each with 15-30 people and all shorter than three months.

Only five small papers exist, so we still do not know if any pill truly helps older clients with ASD.

The trials showed tiny, early gains, but side-effects were tracked poorly.

Bottom line: solid proof for meds in adolescents and adults with autism is almost blank.

Gerow et al. (2018) shows parents can cut problem behavior by teaching communication instead of using drugs.

Chandroo et al. (2018) found teens rarely speak up in their own planning meetings, so behavior plans often ignore self-advocacy skills that could reduce the need for medication.

Boswell et al. (2023) looked at blood chemicals linked to drug pathways and found no differences in ASD, hinting that new pills may not fix a real biological gap.

Together these reviews say: teach skills first, because drug evidence is still thin.

Before you recommend any medicine for an older client with ASD, show families this gap. Try parent-led FCT, self-advocacy training, or other skill plans first. Track behavior data for four weeks. If you later trial a drug, set clear target behaviors and side-effect checks so you add real evidence, not more guesswork.