Summary
An 18-year-old adolescent with an autism spectrum disorder was on antipsychotic medication for anxiety and aggressive behaviour. From a physical examination and the patient’s family medical history there emerged a high-risk profile for the metabolic syndrome. Because the patient refused blood tests the doctors were faced with the dilemma of whether to continue the patient’s medication with the risk of severe side effects or whether to stop medication, which could lead to the recurrence of severe behavioural problems and aggressive behaviour. The dilemma is discussed and some recommendations are given.