Risperidone was one of the most popular psychotropic medications approved by FDA for Autism. It may be used to treat specific disruptive behaviors (i.e. irritability) usually associated with autism.

Due to recent findings, about one-third of children with ASD take an antipsychotic medication and Risperidone may be responsible for the major part, but its place in autism treatment especially out of US has not been clear due to uncertainty about costs and benefits of prescription. We aimed to investigate the risperidone prescription in children with ASD in Iran.

A representative sample of Students of autism specific schools aged 6-15 surveyed through the parents to provide drug list, demographic and developmental information of children; parents were also asked to indicate whether they were currently using or had just used in the past but not currently or never used the risperidone.

Risperidone has been prescribed for 85.2% (98/115) children with ASD while 50.4% were currently using. Sex difference analysis showed that prescription was done for 87% of boys versus 73.9% of girls (p = 0.06). There was a significant lower socioeconomic state in families with current using of risperidone (p < 0.001). Prescription was not associated with comorbidities in children.

We found a very high rate of risperidone use in children with autism. It may be due to treatment approaches rely heavily on the most available psychotropic agent (i.e. risperidone). Further research is warranted in Cost-Benefit Analysis of risperidone use in Autism.