Prescription Drug Rates Among Children with Autism Spectrum Disorders (ASD)

Background: Autism Spectrum Disorder (ASD) is a neurologically based developmental syndrome that affects 1 in 91 children in the United States. Medications are often prescribed for correcting ASD associated problem behaviors, and evidence suggests rates of medication use among children of all ages with ASD are high and increasing. Studies show that 30%-60% of ASD children are currently taking or have within the past year been prescribed at least one psychotropic medication. Additionally, ASD children have substantially higher total healthcare costs, largely due to prescription drugs. However, the generalizability of these findings may be limited by the reliance on parent recall, volunteer participation, or previous diagnoses, and the lack of systematic diagnostic assessments.

Objectives: The aims of this study were to determine rates of prescription medications and comorbid conditions among children with ASD.

Methods: Our study population consisted of 8-year old children with ASD identified by the Centers for Disease Control and Prevention (CDC) sponsored South Carolina Autism Developmental Disabilities Monitoring (SCADDM) Network. All Medicaid-eligible cases from the first three study years (2000, 2002, and 2004) that met DSM-IV criteria for Autistic Disorder (AD), Asperger Disorder (AS), or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) were linked to Medicaid to obtain a history of attention-deficit hyperactivity disorder (ADHD) and epilepsy diagnosis from birth through age 8, and a 2-year history of any prescription medications.

Results: A total of 306 children were included. Overall, 88% (270/306) were prescribed one or more medications, and over 50% (159/306) were prescribed 10 or more during the 2-year medication history (1999-2000 for study year 2000, 2001-2002 for study year 2002, and 2003-2004 for study year 2004). The number of prescriptions per subject was consistent across study years (median=10). Cases with a history of ADHD at any time between birth and age 8 increased from 28% in study year 2000 to 36% in study years 2002 and 2004, while cases with a history of epilepsy at any time between birth and age 8 decreased from 19% in study years 2000 and 2002, to 11% in study year 2004.

Conclusions: To the authors' knowledge, this is the first study to examine rates of medication use among ASD children that were identified by a population based surveillance project. Our findings suggest an even higher rate of medication usage than previously reported and support the need for further research in this area. These results will be beneficial for future comparisons and ultimately a better understanding of the impact of this disorder.