Drugging Distress: How a 'Review' Sells Risperidone & Aripiprazole to Autistic Kids
The Journal of Medicinal and Pharmaceutical Chemistry Research (Vol. 8, Issue 2, 2026) published a narrative literature review by Marina Paramitha and Izzatul Fithriyah. Paramitha is affiliated with the Department of Psychiatry, Faculty of Medicine, Universitas Airlangga and the Department of Psychiatry, Dr. Soetomo General Academic Hospital in Surabaya, Indonesia. Fithriyah is affiliated with the Department of Psychiatry, Faculty of Medicine, Universitas Airlangga and Dr. Soetomo General Academic Hospital in Surabaya, Indonesia.
This paper presents antipsychotics as core tools for controlling autistic behaviour in children as young as five. Its framing treats environmental mismatch, communication barriers and trauma responses as symptoms of an intrinsic disorder that require chemical intervention — not systemic or relational change. The review is written without autistic authorship or input, ensuring the medical model remains uncontested.
The Claims in Plain Language
Two FDA-approved antipsychotics — risperidone and aripiprazole — are promoted as reducing “irritability, aggression and self-injury.” While side effects like rapid weight gain, metabolic disruption, hormonal changes and irreversible movement disorders are noted, they are positioned as manageable trade-offs. The assumption is clear: suppressing behaviour to fit neurotypical expectations is worth the physical and psychological cost.
What Frame Is Driving This?
The review operates entirely within DSM-defined pathology. Clinical authorities decide what is “irritability,” what is “aggression” and when intervention is “necessary.” Autistic experiences of distress are reframed as target symptoms. If autistic people held framing power, the focus would shift to sensory safety, communication access and self-determined pacing. The total absence of lived-experience data is not an oversight — it is an exclusion that keeps drug-based compliance as the default solution.
Mechanism of Harm and Who Benefits
The mechanism is coercive chemical restraint disguised as therapeutic care. Children are given dopamine-blocking drugs that can cause lifelong metabolic and neurological damage, often to stop behaviours that threaten adult comfort not child safety. The beneficiaries are pharmaceutical companies profiting from extended drug patents, clinicians rewarded for “managing” challenging cases quickly and institutions avoiding the expense and discomfort of systemic change.
Methods With Real-World Impact
The monitoring regime — metabolic panels, prolactin levels, AIMS — requires repeated invasive procedures. For many autistic children these are themselves sources of trauma. Short-term trials mask the true scope of risk and no meaningful attention is given to withdrawal effects or the ethical burden of medicating children who cannot give informed consent.
Questions That Leave Autism Intact
- What would distress reduction look like if the environment, not the child, was the primary site of intervention?
- How do autistic-led wellbeing metrics compare to the symptom-reduction scores used in drug trials?
- What is the documented experience of autistic adults who were medicated as children for behavioural control?
- What systems-level changes could replace antipsychotics as a first-line response to autistic distress?
Unsettled Ending — On Purpose
This is not a neutral academic review — it is a roadmap for maintaining structural control over autistic children through pharmaceutical means. Without dismantling the assumption that compliance equals care, “careful monitoring” is nothing more than a safety label on state-sanctioned chemical restraint.