My sister asked me to ask around and see if I could find some alternatives for her son.
Some background: He's 14-years-old and severely autistic. He is non-verbal (though he can communicate through typing or pointing out letters on a board) and has sensitivities to egg, dairy, and gluten. He eats pretty poorly (mostly meat) and will sneak foods he can't tolerate whenever he gets the chance.
Recently he has been struggling. He's a big kid (tall and very strong) and has a terribly explosive temper. He throws and breaks things constantly, screams, scratches and hits himself, tears up rooms, etc. He has also been known to pee on things when he's angry. He could very easily hurt someone when he gets angry. As a result of the violent outbursts his doctor ha been trying some different medications to try to stop the behavior or at least make the outbursts more manageable. His behavior is markedly worse when his 5-year-old sister is present. He does NOT like to share the attention of their mother and gets angry when his sister even talks quietly. So far the meds they have tried either didn't work or made him worse. The doctors have now mentioned Resperdol and Ablilify, but my sister is very concerned about side effects and would like some alternative suggestions.
I'm honestly not too sure where to even start looking...so if anyone has any ideas, suggestions, or experiences to share that would be great! Thanks in advance.
Honestly, Risperdal sounds like the best choice. I know it is an anti-psychotic and that to some people that means bad side effects, but risperdal is a "newer" anti-psychotic, and does not have the side effects that people think of when they think of the older anti-psychotics (like Mellaril, Haldol, Thorazine). Risperdal has been used exactly for this purpose in many, many children and there are rarely any side effects and the child seems a lot more comfortable in their body.
Weight gain is a fairly common side effect, though.
The other medications that might be used in this situation are ones that are worse than anti-psychotics. The class of medication by itself does not always indicate the potential for side effects - you really have to look at the individual medication to make a comparision. For example, Risperdal, an anti-psychotic, has fewer side effects than Effexor, an anti-depressant. Ativan is sometimes a choice for managing aggressive behavior, and it is an anti-anxiety medication, but it would be a far worse choice than Risperdal.
Abilify is newer and I would trust Risperdal over Abilify at this point, really, just because there isn't the enormous amount of experience with Abilify that there is with Risperdal.