Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

PEDIATRICS (Impact Factor: 5.47). 11/2012; 130(Supplement):69-76. DOI: 10.1542/peds.2012-0900D

ABSTRACT Objectives:
The goal of this study was to examine rates of psychotropic medication use and identify associated child and family characteristics among children and adolescents with autism spectrum disorder (ASD) enrolled in an autism registry maintained by the Autism Treatment Network (ATN).

The sample, derived from the ATN registry, consists of 2853 children aged 2 to 17 years with diagnoses of ASD supported by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the Autism Diagnostic Observation Schedule with available data on medication use. As part of initial enrollment in the registry, parents completed questionnaires on current psychotropic medication use, psychiatric and medical conditions, and demographics.

Of the 2853 children, 763 (27%) were taking ≥ 1 psychotropic medication; 15% were prescribed 1 medication, 7.4% received 2 medications, and 4.5% received ≥ 3. Among children aged 3 to 5 years, 11% were taking ≥ 1 psychotropic medication; among 6- to 11-year-old children, 46%; and 66% of adolescents aged 12 to 17 years were taking at ≥ 1 psychotropic medication. A parent report of comorbid diagnosis of attention-deficit/hyperactivity disorder, bipolar disorder, obsessive-compulsive disorder, depression, or anxiety was associated with a high rate of use, with 80% receiving ≥ 1 psychotropic medication. Only 15% of children with no comorbid psychiatric disorder were taking psychotropic medication. Psychotropic medication use was also related to sleep and gastrointestinal problems.

The prescription of psychotropic medications in this registry sample is highly related to comorbid psychiatric disorder. Other factors associated with use include medical comorbidities, race, ethnicity, and older age.

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    • "Previous studies have estimated that between 27% and 60% of children and adolescents received at least one medication for ASD treatment in the United States and Canada [Coury et al., 2012; Frazier et al., 2011; Mandell et al., 2008]. In the United Kingdom, a study using a primary care database reported approximately 29% (1,619/5,651) of young people aged less than 25 years with ASD received psychotropic drugs; and the commonly prescribed drug classes were sleep medications (9.7%), stimulants (7.9%), and antipsychotics (7.3%) [Murray et al., 2014]. "
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    • "Medication Coury et al. (2012) "
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    ABSTRACT: Matson and Nebel-Schwalm (Research in Developmental Disabilities 28(4) 341-352, 2007) conducted an overview of comorbid psychopathology with autism spectrum disorder (ASD) in children. The purpose of the current paper is to expand on Matson and Nebel-Schwalm (Research in Developmental Disabilities 28(4) 341-352, 2007) by discussing the relationship between comorbid psychopathology in ASD and other variables. The current paper will include research across the lifespan, from babies and toddlers to children, adolescents, and adults. Topics explored are the prevalence of comorbid psychological disorders, the importance of studying comorbid psychopathology, as well as the measures used to assess comorbid psychopathology in ASD. Research on the relationships between comorbid psychopathology in ASD and parental and sibling stress and well-being, developmental regression, language and communication, adaptive behavior, social skills, autism severity, challenging behavior, gastrointestinal symptoms, sleep problems, epilepsy, sensory issues, and quality of life is also discussed. Age-related variations in comorbid psychopathology are also examined. Finally, recommendations for treatment are given as well as areas where future research is needed.
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