Safety and Efficacy of Paliperidone Palmitate in Pediatric Patients with Autism and Intellectual Disability.
Monthly paliperidone shots look safe and calm irritability in teens with autism and ID who can’t stick to daily meds.
01Research in Context
What this study did
Doctors looked back at 26 teens and young adults with autism plus intellectual disability. All had trouble taking daily pills for severe irritability.
The team gave each youth one shot of paliperidone palmitate every month for about 21 months. They counted side effects, irritability scores, and hospital visits.
What they found
Most kids handled the shot well. Irritability dropped and trips to the hospital went down.
Families said life felt calmer without the fight of daily medicine.
How this fits with other research
Cervantes et al. (2019) and Mae Simcoe et al. (2018) showed that a full autism care pathway can cut restraints and length of stay in the same hospital. Seth et al. add a drug tool to that pathway.
Konstantareas et al. (1999) also used a long-acting shot, but for sexual behavior in an adult. Both studies hint that monthly shots can help when pills fail.
Reni et al. (2022) and Whaling et al. (2025) lowered irritability with PECS or VR, no drugs. Seth et al. give a medical option when behavioral fixes are not enough.
Why it matters
If you work with teens who spit out pills or need crisis admission, ask the psychiatrist about paliperidone palmitate. One shot a month may keep the youth stable, cut hospital trips, and free you to focus on skill teaching instead of damage control.
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02At a glance
03Original abstract
This retrospective chart review examines the safety, tolerability and effectiveness of long acting injectable paliperidone palmitate (P-LAI) targeting irritability in twenty-six youth and transition-aged individuals with autism spectrum disorder (ASD) and/or intellectual disability (ID) over a 3-year window. Clinical response was evaluated via prospectively assigned Clinical Global Impressions Severity (CGI-S) and Improvement (CGI-I) scales as well as number of hospital presentations. P-LAI was well tolerated with only 3 patients stopping P-LAI due to side effects. The average duration of P-LAI treatment was 21.1 months. Difficulty with medication compliance was the most common reason for initiating P-LAI. There was a statistically significant improvement in CGI-I, CGI-S and hospital visits and no change in BMI noted. Given the potential difficulty of medication administration in this population, this evidence of safety, tolerability as well as preliminary data supporting effectiveness is an important addition to the literature regarding psychopharmacologic management of irritability in youth with ASD and ID.
Journal of autism and developmental disorders, 2024 · doi:10.1007/s00213-012-2711-3