Abstract
Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) significantly impact mental health, increasing the risk of severe behaviors, including suicidality. This case report examines a 13-year-old boy with ASD and ADHD who presented to the emergency department with homicidal and suicidal ideations. Despite being prescribed risperidone and carbamazepine, his noncompliance with medication and therapy, combined with significant social stressors like physical abuse by his stepfather and his mother's mental health issues, exacerbated his condition. His aggressive actions toward siblings and self-harm attempts highlight the severe behavioral manifestations of these conditions. The case underscores the necessity for comprehensive and consistent intervention strategies, robust support systems, and regular follow-ups to manage ASD and ADHD effectively and mitigate the risk of severe outcomes.