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Therapies & support

Medication in autism: possibilities and limits

Who is it for? For parents, relatives and people on the autism spectrum who want to know what medication is used for and what it is not used for.

In brief

The 2021 S3 guideline stated: there is no drug therapy that improves social interaction and communication. Psychotropic or other medicines should therefore not be used for this goal. [1, Rec. 20] Medication can, however, be helpful for co-occurring conditions, for example in ADHD. [1, Rec. 21, 69] The guideline expired on 23.03.2026. [2]

This English translation was produced with AI assistance and has not yet been independently reviewed.

Status of the guideline: This article uses the S3 guideline on therapy (2021). It expired on 23.03.2026. [2] The statements are not automatically wrong, but they are not backed by a valid guideline.

What medication does not do

Autism is not an illness that can be “treated” with a medicine. According to the guideline, there is currently no drug therapy that leads to an improvement in social interaction and communication; it should not be used for this therapy goal (consensus-based, strong consensus). [1, Rec. 20]

When medication for co-occurring conditions can be helpful

The guideline stated: drug treatment of a co-occurring condition can be helpful, for example to make participation in group therapy possible. Named were ADHD, in severe forms stereotyped and repetitive as well as oppositional or aggressive behaviours, anxiety disorders and depressive episodes. [1, Rec. 21] The decision is made by a doctor together with you.

ADHD as an example

For children and adolescents with autism and additional ADHD, the guideline recommended (grade of recommendation A): methylphenidate and atomoxetine are effective and should be used primarily when ADHD is diagnosed. Guanfacine can come into question as a third alternative if certain requirements are met. [1, Rec. 69] The guideline pointed out that in children and adolescents with autism, undesirable effects can occur more often and more markedly; titration should therefore start at the lowest possible dose and be increased more slowly. [1, Rec. 69] Side effects to be monitored included loss of appetite, sleep disorders, irritability, gastrointestinal complaints as well as dizziness and tiredness. [1, Rec. 69] For adults, the procedure should be analogous. [1, Rec. 70] More on this: Autism and ADHD.

Omega-3 preparations and gluten- or casein-free diets should, according to the guideline, not be used to treat ADHD symptoms in autism because of insufficient effectiveness. [1, Rec. 69] Antipsychotics should, because of their unfavourable side-effect profile, only be used for additional oppositional and aggressive behaviours. [1, Rec. 69]

What else you should know

Note: This article offers general information. It does not replace personal advice or treatment by professionals.

Sources and literature

  1. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 2: Therapie. S3-Leitlinie, AWMF-Reg.-Nr. 028-047, Stand Text 02.05.2021 (Empf. 20, 21, 69, 70). – Guideline (in German); expired on 23 March 2026 (see no. 2)
  2. DGKJP. Aktuelle Leitlinien (Eintrag 028-047: „Gültig bis 23.03.2026“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)

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