Relationship Between Antipsychotic Use and Cholesterol Levels in a Retrospective Chart Review of an Adult Autism Clinic Patient Population.
In adults with ASD, antipsychotics did not raise cholesterol or weight—monitor age, not just the pill.
01Research in Context
What this study did
Cejas et al. (2025) pulled the adult charts from one autism clinic.
Half the adults took antipsychotics, half did not.
The team compared weight, cholesterol, triglycerides, and gut problems between the two groups.
What they found
The drug group looked the same as the no-drug group on every measure.
BMI, total cholesterol, triglycerides, and GI issues did not differ.
Cholesterol went up with age in both groups, but the pills did not speed it up.
How this fits with other research
Mahé et al. (2025) looked at the same clinic files and found that adults with IDD, epilepsy, or severe behavior are the ones most likely to get the drugs.
Soto et al. (2024) showed that a short emotional-development assessment lets clinicians cut antipsychotic dose without harm.
Together the three papers tell a simple story: the people who get the drugs are high-risk, yet the drugs do not wreck metabolism, and you can often taper them safely.
Yamashiro et al. (2019) warned that adults with ASD in day programs swallow more psychotropics than peers without ASD; Gregory’s data say those extra pills are not automatically hurting cholesterol or weight.
Why it matters
You can stop assuming that every antipsychotic pill is clogging arteries.
Check cholesterol because age matters, not just because of the prescription.
If the behavior plan is solid, consider a slow taper—F et al. already showed it works.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Plot your client’s last two cholesterol values against age, then ask the psychiatrist if a taper trial fits the behavior data.
02At a glance
03Original abstract
Individuals with autism spectrum disorder (ASD) experience a high prevalence of metabolic and gastrointestinal (GI) comorbidities. Antipsychotics are commonly prescribed for adults with ASD. Our study investigated the effect of antipsychotic medication on metabolic and GI comorbidities, as well as effects across age, in an adult ASD population. We retrospectively analyzed 279 charts from patients with ASD, ages 16-62 (mean = 27.97, SD = 8.89, 18.3% female). Data abstracted included demographic information, medications taken, GI and metabolic comorbidities, and recent values for body mass index (BMI), triglycerides, and total cholesterol. Participants were separated into two groups based on antipsychotic use. Between-group differences were calculated for the prevalence of GI comorbidities and mean values for BMI, triglycerides, and total cholesterol. Lastly, binary correlations were calculated for age and total cholesterol as well as triglycerides, and age and BMI. No significant difference was found between the prevalence of GI comorbidities for the two groups. For metabolic factors, no significant difference was found in the mean BMI, triglycerides, or total cholesterol. Binary correlation analysis also revealed no significant correlation between age and BMI or triglycerides for patients in either group. A significant correlation was found between age and total cholesterol for patients both taking and not taking antipsychotics. Despite approximately one in three patients in this study taking an antipsychotic medication, no significant differences in GI or metabolic comorbidities were found. However, cholesterol increased with age regardless of the presence or absence of antipsychotics. Future research is needed to better understand the long-term effects of antipsychotics on adults with ASD and metabolic monitoring in those not on antipsychotics.
Autism research : official journal of the International Society for Autism Research, 2025 · doi:10.1002/aur.70047