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This review is intended to provide an update of recent advances in psychopharmacology to support evidence-based prescription of psychotropic medications for autism spectrum disorders.Pharmacotherapy continues to be an important component of a comprehensive treatment program for autism spectrum disorders. Evidence is accumulating supporting the use of second-generation antipsychotic medications and selective serotonin reuptake inhibitors. Recent studies suggest that they are effective and relatively well tolerated, not only in the adult population but also in children with this disorder. Other approaches, such as the use of acetylcholinesterase inhibitors, anticonvulsants and dietary enzymes, may also be potentially useful, but further research on these compounds is needed.One of the intriguing aspects of autism spectrum disorders is the unclear pathogenesis. In the absence of any definite evidence of neurochemical abnormalities, there is currently no medication that can be used for the curative treatment of this disorder. However, many distressing symptoms and aberrant behaviors, such as severe tantrums, aggression, hyperactivity and self-injurious behaviors, can be targeted by pharmacotherapy. Amelioration of these symptoms will enhance the individual's ability to participate in educational and community programs, as well as reducing the stress experienced by the carers.