A study published Monday in the journal Pediatrics finds that approximately two thirds of children diagnosed with autism spectrum disorder (ASD) have a prescription for at least one psychotropic medication.
Currently, there is no research to support prescribing psychotropic drugs for the treatment of ASD.
The researchers looked at data from 33, 565 children diagnosed with ASD using administrative medical and pharmacy claims information linked with health plan enrollment and demographic information from 2001 to 2009.
Among the children surveyed, 64% had a prescription for at least one medication, 35% were given two medications concurrently and 15% were taking more than three medications. Co-occurring conditions, such as depression, bipolar disorder and attention-deficit disorder, were the highest predictor of being prescribed one or more psychotropic drugs.
Furthermore, the data indicated that children in Southern states and children of Hispanic descent were more likely to be prescribed psychotropic drugs, while children of Asian descent were more likely to be prescribed multiple psychotropic drugs. Children located in the Northeastern and Western regions of the United States were less likely to receive prescriptions for such drugs. Household income was not found to be a factor.
The study pointed to a lack of access to evidence-based, early intervention behavioral therapy in certain regions of the United States, such as the South, leading to an increase in the rate of prescribing psychotropic medications. They also pointed to safety concerns because many of these medications have already exhibited safety issues when used by themselves and the potential for toxicity could increase when medications are combined.
Despite minimal evidence of the effectiveness or appropriateness of multidrug treatment of ASD, psychotropic medications are commonly used, singly and in combination, for ASD and its co-occurring conditions... Our study underscores an immediate need to develop standards of care around the prescription of psychotropic medications based on the best available evidence and a coordinated, multidisciplinary approach to improving the health and quality of life of children with ASD and their families. Lastly, it calls for additional research investigating current practice patterns and access to services and emphasizes the need for rigorous trials of psychotropic medications for children with ASD and other psychiatric disorders to assess the value of these medications when weighed against their potential for harm.
This study underscores not only the need for further research into the causes and treatment of autism, but the need for evidence-based treatments, such as Applied Behavior Analysis (ABA) therapy, to be more readily available across the country. There has been some progress with recent legislation in California and nationally mandating that insurance companies cover ABA therapy. However, based on the aforementioned study, it is clear that there isn't a clear consensus in the medical community regarding the appropriate treatment for ASD.
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