Risperidone improves behavioral symptoms in children with autism in a randomized, double-blind, placebo-controlled trial.

Researchers ran a double-blind, placebo-controlled trial of risperidone in children aged 5-12 with autism. Kids got either 1.37 mg of risperidone or a look-alike pill every day. The team tracked irritability using the ABC-I scale for eight weeks.

No one knew who got the real drug until the final numbers were locked.

Risperidone beat placebo by about six points on the 45-point irritability scale. Three out of four children on the drug felt sleepy, but the aggression and tantrums dropped. The result was medium-sized and statistically clear.

Placebo kids showed little change.

Hanley et al. (1997) saw the same benefit in an earlier, smaller case series of older youth with autism and intellectual disability. Their open-label design lacked a control group, so the 2007 RCT now gives stronger evidence.

Fovel et al. (1989) and Skrtic et al. (1982) tested haloperidol, another antipsychotic, in similar placebo-controlled trials. Haloperidol also cut behavior problems, but it could slow learning. Risperidone updates the field by showing equal calming with a newer drug.

Parsons et al. (2013) reviewed 24 medication trials and warned that long-term safety data are still thin. The 2007 study adds one solid brick, yet the call for longer follow-up remains.

If you work with autistic children who hit, scream, or self-injure, this paper gives you an evidence-based option to discuss with the prescribing doctor. Pair the data with sleep and weight monitoring, and keep behavior plans in place—pills calm, but skills teach.