Autism spectrum disorders and their treatment with psychotropic medications in a nationally representative outpatient sample: 1994–2009

Kamimura-Nishimura, Kelly; Froehlich, Tanya E.; Chirdkiatgumchai, Vilawan; Adams, Richard H.; Fredstrom, Bridget K.; Manning, Patty

doi:10.1016/j.annepidem.2017.06.001

“…Overall, the proportions of treated individuals were in line with a previous Swedish study on cross-sectional data from the PDR [27]. On the other hand, the number of treated individuals was higher in comparison to results from a Danish register study [28], and lower in relation to a US cohort in which 86% of children with combined ASD and ADHD received psychostimulants [29]. Yet, our findings indicate that individuals with ADHD and coexisting ASD and regardless of age group are less likely to start continuous treatment with ADHD medication.…”

Section: Discussionsupporting

confidence: 87%

Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register

Johansson

¹

,

Sandin

²

,

Chang

³

et al. 2020

J Neurodevelop Disord

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Background Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD. Methods Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5012 individuals with ADHD and coexisting ASD, aged between 3 and 80 years. The first treatment episode with ADHD medications (≥ 2 filled prescriptions within 90 days) and daily doses of methylphenidate during a 3-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day. Results Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR, 0.80; 95% confidence interval, 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine, or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD. Conclusions The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians’ perceptions of medication effects in patients with ASD, needs to be further studied.

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“…Overall, the proportions of treated individuals were in line with a previous Swedish study on cross-sectional data from the PDR [27]. On the other hand, the number of treated individuals was higher in comparison to results from a Danish register study [28], and lower in relation to a US cohort in which 86% of children with combined ASD and ADHD received psychostimulants [29]. Yet, our ndings indicate that individuals with ADHD and coexisting ASD and regardless of age group are less likely to start continuous treatment with ADHD medication.…”

Section: Discussionsupporting

confidence: 87%

Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish Prescribed Drug register

Johansson

¹

,

Sandin

²

,

Chang

³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background. Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD.Methods. Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5,012 individuals with ADHD and coexisting ASD, aged between 3 to 80 years. The first treatment episode with ADHD medications (≥2 filled prescriptions within 90 days) and daily doses of methylphenidate during a three-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day.Results. Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR; 0.80, 95% Confidence Interval: 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD.Conclusions. The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians’ perceptions of medication effects in patients with ASD, needs to be further studied.

show abstract

“…Overall, the proportions of treated individuals were in line with a previous Swedish study on cross-sectional data from the PDR [27]. On the other hand was the number of treated individuals higher in comparison to results from a Danish register study [28], and lower in relation to a US cohort in which 86% of children with combined ASD and ADHD received psychostimulants [29]. Yet, our ndings indicate that individuals with ADHD and coexisting ASD are less likely to start continuous treatment with ADHD medication.…”

Section: Discussionsupporting

confidence: 87%

Medications for Attention-deficit/hyperactivity Disorder in Individuals With or Without Coexisting Autism Spectrum Disorder: Analysis of Data From the Swedish Prescribed Drug Register

Johansson

¹

,

Sandin

²

,

Chang

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background. Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD.Methods. Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5,012 individuals with ADHD and coexisting ASD, aged between 3 to 80 years. The first treatment episode with ADHD medications (≥2 filled prescriptions within 90 days) and daily doses of methylphenidate during a three-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day.Results. Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR; 0.80, 95% Confidence Interval: 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD.Conclusions. The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians’ perceptions of medication effects in patients with ASD, needs to be further studied.

show abstract

Autism spectrum disorders and their treatment with psychotropic medications in a nationally representative outpatient sample: 1994–2009

Cited by 14 publications

References 47 publications

Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register

Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register

Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish Prescribed Drug register

Medications for Attention-deficit/hyperactivity Disorder in Individuals With or Without Coexisting Autism Spectrum Disorder: Analysis of Data From the Swedish Prescribed Drug Register

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