Psychotropic Medication Use among Insured Children with Autism Spectrum Disorder.
This study examined psychotropic medication use among 7901 children aged 1-17 with autism spectrum disorder (ASD) in five health systems, comparing to matched cohorts with no ASD. Nearly half (48.5 %) of children with ASD received psychotropics in the year observed; the most common classes were stimulants, alpha-agonists, or atomoxetine (30.2 %), antipsychotics (20.5 %), and antidepressants (17.8 %). Psychotropic treatment was far more prevalent among children with ASD, as compared to children with no ASD (7.7 % overall), even within strata defined by the presence or absence of other psychiatric diagnoses. The widespread use of psychotropics we observed, particularly given weak evidence supporting the effectiveness of these medications for most children with ASD, highlights challenges in ASD treatment and the need for greater investment in its evaluation.
Department of Pharmacy and Health Systems Sciences, School of Pharmacy, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Avenue R218X TF, Boston, MA, 02115, USA. j.madden@northeastern.edu.|Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. j.madden@northeastern.edu.
Jeanne M
JM
Madden
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Matthew D
MD
Lakoma
The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
Frances L
FL
Lynch
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.|Massachusetts General Hospital, Boston, MA, USA.
Donna
D
Rusinak
School of Public Health, Georgia State University, Atlanta, GA, USA.|Kaiser Permanente Georgia, Center for Clinical and Outcomes Research, Atlanta, GA, USA.
Ashli A
AA
Owen-Smith
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Karen J
KJ
Coleman
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Virginia P
VP
Quinn
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.|McKesson Corporation, San Francisco, CA, USA.
Vincent M
VM
Yau
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Yinge X
YX
Qian
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Lisa A
LA
Croen
D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000069445:Atomoxetine Hydrochloride / Q000627:therapeutic use; D000067877:Autism Spectrum Disorder / Q000188:drug therapy*; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D014481:United States
D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D011619:Psychotropic Drugs; D000069445:Atomoxetine Hydrochloride
Antipsychotics; Autism spectrum disorder; Comorbidities; Epidemiological studies; Medications