When first-line treatments fail, should clozapine be considered for severe aggression in autistic youth? A retrospective chart review suggests reduced hospital visits and meaningful clinical improvement in carefully monitored patients. We review who might benefit—and how to balance efficacy with safety and monitoring demands.

Can high-dose propranolol reduce severe aggression in autistic adolescents? A small pilot crossover trial suggests promising improvements, though cardiovascular monitoring remains essential. We examine the data, practical limitations, and how this approach fits into a thoughtful, stepwise treatment algorithm.