Psychotropic Medication Trends Among Children and Youth Diagnosed with Autism Spectrum Disorder in a Specialized Paediatric Clinic
Psychotropic medications are primarily directed towards treating comorbid symptoms, rather than core symptoms of autism spectrum disorder (ASD) in children. The rate of polypharmacy among children with ASD ranges from 10-20%. There is a paucity of studies examining psychotropic medication use over time among children with ASD.
This study examined if there is an effect of an ASD diagnosis on the number and change in the number of medication classes at two time points (year 1 and year 5) compared to baseline (time of initial consult).
Medical records of children seen in a Psychopharmacology Clinic in a tertiary hospital setting in Toronto, Canada during 2006 and 2013 were reviewed. Cases were divided into two groups, namely i) ASD and ii) non-ASD. The variation on the number and types of psychotropic medication classes based on psychiatric, medical diagnosis and behavioural symptomatology was examined.
Three hundred and five medical records were included in the review. Eighty three percent (254/305) of cases had a diagnosis of ASD and 16.7% (51/305) non-ASD. The majority of cases (76%) were referred for irritability and aggression. A greater number of cases with ASD (45.2%) were on one psychotropic medication class and 23.6% were on two psychotropic medication classes at their initial consult. Antipsychotics were the most commonly prescribed medication class. Cases were more likely to be prescribed more psychotropic medications than taken off at the initial consult. The number of subjects who went on or off psychotropic medication was similar between groups with the ASD group slightly more likely to increase medications. An increased number of psychotropic medication classes were 2 to 3 three times more likely to occur than a decrease in the number of classes at the first year consult.
Among children with ASD, prescribing trends remain relatively stable with one to two classes of psychotropic agents. There is no effect of an ASD diagnosis in the number and change pf medication classes over time.