An Overview of Pharmacotherapy in the Management of Children with Autism Spectrum Disorder at a Public Hospital in KwaZulu-Natal

Abstract

This study presents an overview of prescribing patterns and provides insight into the current management practice for the core symptoms and comorbidities of ASD in children. A quantitative retrospective study was conducted at a public hospital in KwaZulu-Natal, South Africa by reviewing patient files of children diagnosed with ASD and meeting the inclusion criteria for the study. A descriptive analysis of data was done to identify treatment trends and patient therapeutic outcomes. A total of 181 children met the inclusion criteria of the study. Risperidone was the most frequently prescribed drug (88%) for the management of comorbidities and/or core symptoms of ASD. Drugs prescribed to manage ASD comorbidities included methylphenidate, melatonin, sodium valproate, risperidone, oxybutynin, carbamazepine, and others. Except for risperidone, there were no additional drugs that targeted the core symptoms of ASD. Non-pharmacological therapies were often used collaboratively with medication to manage ASD symptoms. In 41% of patients, there were improvements in their symptoms.

Clinical profile of children and adolescents with autism spectrum disorder in Durban, South Africa

“…In this study, 37 of the 67 children and adolescents were diagnosed with ADHD (55.2%), which is in keeping with findings of another study at a paediatric neurology public hospital in KwaZulu-Natal, which reported a 57% prevalence rate of ADHD. 70 The finding in this study that 29.9% of patients had a comorbid diagnosis of epilepsy is consistent with other studies such as 30.0% prevalence of comorbid seizure disorders in ASD in a study by Maniram et al in 2023. 70 Varying rates of epilepsy have been found and other studies have reported different rates; for example, Mannion et al found that 10.1% of children and adolescents with ASD had a comorbid diagnosis of epilepsy.…”

“…Similarly, Maniram et al report that less than half (44%) of patients were being seen by speech and/or occupational therapy, of whom, 23% were recommended by the prescriber of the pharmacological management. 70 With regards to medication in this study, all those with ASD were on psychotropic medication and 40 patients (59.7%) were on more than one, the most widely used being anticonvulsants (59.7%), risperidone (53.7%), and methylphenidate (28.4%). This is consistent with a systematic literature review by Ritter et al, which found that most of the youth with ASD were taking two or more medications, psychotropic or non-psychotropic, simultaneously.…”

“…In this study, 37 of the 67 children and adolescents were diagnosed with ADHD (55.2%), which is in keeping with findings of another study at a paediatric neurology public hospital in KwaZulu-Natal, which reported a 57% prevalence rate of ADHD. 70 …”

“…The finding in this study that 29.9% of patients had a comorbid diagnosis of epilepsy is consistent with other studies such as 30.0% prevalence of comorbid seizure disorders in ASD in a study by Maniram et al in 2023. 70 Varying rates of epilepsy have been found and other studies have reported different rates; for example, Mannion et al found that 10.1% of children and adolescents with ASD had a comorbid diagnosis of epilepsy. 67 Epilepsy in ASD is associated with intellectual disability and the more severe the intellectual disability, the higher the prevalence of epilepsy.…”

“…Similarly, Maniram et al report that less than half (44%) of patients were being seen by speech and/or occupational therapy, of whom, 23% were recommended by the prescriber of the pharmacological management. 70 …”