NICE emphasises that biomedical interventions – pharmacological, physical or dietary – should not be used to ‘treat’ autism in adults. The following should not be used for managing the core features of autism in adults:3

·       anticonvulsants
·       chelation therapies
·       exclusion diets
·       dietary supplements
·       drugs designed to improve cognitive function such as cholinesterase inhibitors
·       oxytocin
·       secretin
·       testosterone
·       hyperbaric oxygen
·       antipsychotics
·       antidepressants.

Before initiating other interventions for behaviour that challenges, it is important to address any identified factors that may trigger or maintain the behaviour. This could be done, for example, by:
·       providing the appropriate care for physical disorders such as gastrointestinal problems or chronic pain.
·       treating co-existing mental health disorders with psychological or pharmacological interventions in line with existing NICE guidance for those conditions; or
·       changing the physical or social environment.

Only if psychosocial or other interventions cannot be delivered because of the severity of the behaviour that challenges should antipsychotic medication (prescribed off-label) be considered by a specialist. This should be assessed regularly and discontinued after six weeks if there is no clinically important response.