Risperidone and Aripiprazole in the Management of Aggression and Sensory Hypersensitivity in Children with Autism Spectrum Disorder (Levels 2 and 3) Under 10 Years of Age: Systematic Review and Meta-Analysis (2016–2026)

• DOI: https://doi.org/10.22533/at.ed.0159642620039

• Palavras-chave: Autism Spectrum Disorder; Risperidone; Aripiprazole; Aggression; Meta-analysis.

• Keywords: Autism Spectrum Disorder; Risperidone; Aripiprazole; Aggression; Meta-analysis.

• Abstract:

  INTRODUCTION: Autism Spectrum Disorder (ASD) at support levels 2 and 3 in children under 10 years of age is often accompanied by severe aggression and sensory hypersensitivity. Risperidone and aripiprazole are the main drugs used, but the clinical choice remains debated. OBJECTIVES: To compare the efficacy and safety of risperidone and aripiprazole in managing aggression and sensory symptoms in this population. METHODOLOGY: Systematic review and meta-analysis based on the PRISMA 2020 protocol. Searches in PubMed, Cochrane, and Embase (2016–2026) identified 14 eligible articles (8 for quantitative synthesis). A random-effects model and Hedges’ g for effect size calculation were used. RESULTS: Both drugs demonstrated robust efficacy in reducing irritability (ABC-I). Risperidone showed a g = -0.84 (95% CI: -0.98 to -0.70) and aripiprazole a g = -0.76 (95% CI: -0.90 to -0.62), with no statistically significant difference between the groups (p = 0.18). Risperidone was associated with greater weight gain and hyperprolactinemia, while aripiprazole was associated with a higher incidence of akathisia. Sensory improvement was indirect and equivalent between the interventions. CONCLUSION: Risperidone and aripiprazole have equivalent clinical efficacy for aggression in children <10 years of age. The therapeutic decision should be guided by the profile of adverse effects and metabolic comorbidities.