What pharmacological management do you consider for self-injurious behavior in patients with autism spectrum disorder?  

This is a great question but requires a nuanced answer. It all depends. In short, what I think the clinician needs to know is whether the patient with ASD and self-injury has a treatable condition that is driving self-injury. Perhaps the most critical is whether the patient has a medical problem th...

Great helpful insights from everyone. The only thing I might add from an inpatient perspective, aside from the advantage of being able to do a medical workup in a quicker time frame, is the ability to monitor dietary intake and bowel movements. I would like to emphasize how many parents believe in t...

Superb response by Dr. @Walkup! I would add that ASD treatment should never be on an island and that it is a team-based approach. I never started medication until I had a thorough evaluation from a behavioral analyst. All too often, self-injury gets reinforced. I remember a facility brought a patie...

In psychiatry and medicine in general, we often face the reality that many of our pharmacological interventions don't actually "cure" disorders. Instead, they focus on managing the symptoms associated with these diagnosed conditions. This is particularly true in the treatment of self-injurious ...

Terrific answers all. I often find that self-injurious (and aggressive) behavior in this population can represent frustration arising from a concurrent communication and/or processing disorder. In the workup of these kids, getting a full audiology and auditory processing evaluation and a more detai...

Thank you all for your thoughts and wisdom.  I find a referral to the behavioral parent training program in my part of the country invaluable (at UCLA) and the kids are on a track.  The amount of consistent behavioral changes (ignoring the behavior, redirect, be consistent) I have witnes...

If you are looking for opinions on what meds (other than antipsychotics) might be helpful, I have found clonidine (especially clonidine patch), guanfacine, and Depakote to be therapeutic in some ASD patients. My experience with naltrexone is that it hasn't been especially helpful but I think it's st...

I certainly agree with the emphasis on the underlying cause and treating it if found. When symptoms must be treated emergently, a benzodiazepine and/or antipsychotic can be helpful.