title: Pharmacological treatments prescribed to people with autism spectrum disorder (ASD) in primary health care.
abstract: BACKGROUND
  Autism spectrum disorders (ASDs) affect 1 % of children, having significant impact on health and social outcomes. Psychotropic medication use by individuals with ASD in the USA increased over time, and polypharmacy occurred in >50 % of those prescribed. In the UK, no psychotropic drugs are approved in ASDs, and little is known about patterns of pharmacological treatment in the ASD population and associated co-morbidities.
  
  
  METHODS
  We used The Health Improvement Network, a nationally representative primary care database, to assess the prevalence of ASD diagnoses, psychotropic drug prescribing and neuropsychiatric co-morbidities of 0-24 year olds between 1992 and 2008.
  
  
  RESULTS
  ASD prevalence increased 65-fold from 0.01 % (1992) to 0.50 % (2008). Psychotropic drugs were prescribed to 29 % (1,619/5,651) of the ASD cohort; the most prescribed drugs were sleep medication (9.7 % of prescribed patients), psychostimulants (7.9 %) and antipsychotics (7.3 %). More patients were given psychostimulants and sleep medications over time from 1.5-6.3 % and 2.2-5.9 % respectively. Thirty-seven per cent of the cohort had ≥ 1 record of a neuropsychiatric co-morbidity, the most common being developmental difficulties and learning disabilities (12.6 %), behavioural, conduct and personality disorders (11.1 %) and attention deficit hyperactivity disorder (7.5 %).
  
  
  CONCLUSIONS
  British physicians are more conservative in prescribing practice than American colleagues. However, use of psychostimulants and antipsychotics is much higher in those with ASD than in the general population. Polypharmacy was seen in 34 % of prescribed patients in 2008. Additional studies examining use, efficacy, and long-term safety of antipsychotics and psychostimulants in autistic individuals are warranted.
authors.affiliation: Centre for Paediatric Pharmacy Research, Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK, macey.murray@ucl.ac.uk.
authors.forename: Macey L
authors.initials: ML
authors.lastname: Murray
authors.forename: Yingfen
authors.initials: Y
authors.lastname: Hsia
authors.forename: Karen
authors.initials: K
authors.lastname: Glaser
authors.forename: Emily
authors.initials: E
authors.lastname: Simonoff
authors.forename: Declan G M
authors.initials: DG
authors.lastname: Murphy
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Asherson
authors.forename: Hanna
authors.initials: H
authors.lastname: Eklund
authors.forename: Ian C K
authors.initials: IC
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000188:drug therapy* / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D011619:Psychotropic Drugs