title: Prevalence and correlates of psychotropic medication use in adolescents with an autism spectrum disorder with and without caregiver-reported attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  Many youths with an autism spectrum disorder (ASD) benefit from psychotropic medication treatment of co-morbid symptom patterns consistent with attention-deficit/hyperactivity disorder (ADHD). The lack of clear indications and algorithms to direct clinical practice has led to a very poor understanding of overall medication use for these youths. The present study examined the prevalence of psychotropic medication use compared across individuals with an ASD without a caregiver-reported ADHD diagnosis (ASD-only), ADHD without ASD (ADHD-only), and an ASD with co-morbid ADHD (ASD+ADHD). Correlates of medication use were also examined.
  
  
  METHODS
  Data on psychotropic medication from the first wave of the National Longitudinal Transition Study 2, a nationally representative study of adolescents ages 13-17 in special education, were used to compare the prevalence of medication use across the three groups, overall and by class. Separate logistic regression models were constructed for each group to examine the correlates of psychotropic medication use. Poisson regression models were used to examine correlates of the number of medications.
  
  
  RESULTS
  Youths with ASD+ADHD had the highest rates of use (58.2%), followed by youths with ADHD-only (49.0%) and youths with ASD-only (34.3%). Youths with an ASD, both ASD-only and ASD+ADHD, used medications across a variety of medication classes, whereas stimulants were dominant among youths with ADHD-only. African American youths with ASD-only and with ASD+ADHD were less likely to receive medication than white youths, whereas race was not associated with medication use in the ADHD-only group.
  
  
  CONCLUSIONS
  Clearer practice parameters for ADHD have likely contributed to more consistency in treatment, whereas treatment for ASD reflects a trial and error approach based on associated symptom patterns. Additional studies examining the treatment of core and associated ASD symptoms are needed to guide pharmacologic treatment of these youths. Interventions targeting African American youths with ASD and the physicians who serve them are also warranted.
authors.affiliation: Center for Autism and Center for Pediatric Behavioral Health, The Cleveland Clinic, Cleveland, Ohio 44195, USA. fraziet2@ccf.org
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Frazier
authors.forename: Paul T
authors.initials: PT
authors.lastname: Shattuck
authors.forename: Sarah Carter
authors.initials: SC
authors.lastname: Narendorf
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Cooper
authors.forename: Mary
authors.initials: M
authors.lastname: Wagner
authors.forename: Edward L
authors.initials: EL
authors.lastname: Spitznagel
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D017028:Caregivers; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000150:complications / Q000188:drug therapy*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015233:Models, Statistical; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D044469:Racial Groups / Q000706:statistics & numerical data; D014481:United States
chemical_list: D011619:Psychotropic Drugs