Psychotropic Medication Use Among Children With Autism Spectrum Disorders Enrolled in a National Registry, 2007–2008

Rosenberg, Rebecca E.; Mandell, David S.; Farmer, Janet E.; Law, Kiely; Marvin, Alison R.; Law, Paul A.

doi:10.1007/s10803-009-0878-1

Cited by 141 publications

(150 citation statements)

References 30 publications

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“…Our findings are consistent with, but slightly higher than, previously reported rates based on Medicaid claims data 7 or parental report 11,12 for similarly aged samples of children with ASD. Our increased rates may reflect the longer time periods over which many of our study subjects were observed (.3 years on average compared with 1 year or a single point in time in other studies).…”

Section: Discussionsupporting

confidence: 90%

“…1,3,7,11 These conditions included seizures/ epilepsy, ADD, anxiety, depression, and bipolar disorder. For depression, anxiety, and bipolar disorder, subjects had to have at least 2 medical claims with the relevant diagnosis codes in any position at least 30 days apart.…”

Section: Independent Variablesmentioning

confidence: 99%

“…[6][7][8][9][10][11][12] General concerns about these medications include the lack of evidence documenting the safety or effectiveness of psychotropic treatment during childhood, when developing brains and bodies may be particularly vulnerable to environmental or biological influences. 7,8,13 For ASD treatment in particular, the only US Food and Drug Administration-approved medications are risperidone and aripiprazole (indicated for the treatment of irritability [including symptoms of aggression] in 2006 and 2009, respectively).…”

mentioning

confidence: 99%

“…Reported rates of use among children with ASD have ranged from 27% to 83%, with polypharmacy ranging from 10% to 20%. [6][7][8][9][10][11][12] The rates reported to date have either been based on a fairly limited time period (1 year) or reflect a single point in time and therefore do not yield information about the chronic use of psychotropic medications. Furthermore, all previous studies about psychotropic use and related factors for children who are commercially insured (who comprise the majority of children in the United States 16 ) have been based on parental report and included relatively small sample sizes (from 326 to 5181).…”

mentioning

confidence: 99%

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Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders

2013

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Psychotropic use is common and increasing in children with mental disorders but little is known about the long-term patterns of psychotropic use and polypharmacy among commercially insured children with autism spectrum disorders. WHAT THIS STUDY ADDS:Among 33 565 children with autism spectrum disorders, 64% used psychotropic medications and 35% had evidence of polypharmacy. Older children and those who had seizures, attention-deficit disorders, anxiety, bipolar disorder, or depression had increased risk of psychotropic use and polypharmacy.abstract OBJECTIVE: The objectives of this study were to examine rates and predictors of psychotropic use and multiclass polypharmacy among commercially insured children with autism spectrum disorders (ASD).METHODS: This retrospective observational study used administrative medical and pharmacy claims data linked with health plan enrollment and sociodemographic information from 2001 to 2009. Children with ASD were identified by using a validated ASD case algorithm. Psychotropic polypharmacy was defined as concurrent medication fills across $2 classes for at least 30 days. Multinomial logistic regression was used to model 5 categories of psychotropic use and multiclass polypharmacy. RESULTS:Among 33 565 children with ASD, 64% had a filled prescription for at least 1 psychotropic medication, 35% had evidence of psychotropic polypharmacy ($2 classes), and 15% used medications from $3 classes concurrently. Among children with polypharmacy, the median length of polypharmacy was 346 days. Older children, those who had a psychiatrist visit, and those with evidence of cooccurring conditions (seizures, attention-deficit disorders, anxiety, bipolar disorder, or depression) had higher odds of psychotropic use and/or polypharmacy.CONCLUSIONS: 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 cooccurring conditions. Our results indicate the need to develop standards of care around the prescription of psychotropic medications to children with ASD. Pediatrics 2013;132:833-840

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Section: Discussionsupporting

confidence: 90%

Section: Independent Variablesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders

2013

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“…24 Several largescale studies have reported the use of SRIs among a substantial minority of children with ASD. [25][26][27] The goal of this meta-analysis was to examine the randomized, placebo-controlled trials of SRIs in ASD to determine the efficacy of these medications in treating repetitive behaviors. We examined possible moderators of SRI efficacy in the ASD population by means of stratified analyses and meta-regression.…”

mentioning

confidence: 99%

Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication Bias

2012

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WHAT'S KNOWN ON THIS SUBJECT: Although several randomized trials have examined the efficacy of serotonin receptor inhibitors in the treatment of repetitive behaviors, there still remains clinical uncertainty as to whether these agents are effective in treating such behaviors in children and adults with autism spectrum disorders. WHAT THIS STUDY ADDS:The goal of this meta-analysis was to examine randomized trials of serotonin receptor inhibitors for treating repetitive behaviors in autism spectrum disorders. Although a small but significant effect of these agents was observed, this effect is likely due to the selective publication of trial results.abstract OBJECTIVE: The goal of this study was to examine the efficacy of serotonin receptor inhibitors (SRIs) for the treatment of repetitive behaviors in autism spectrum disorders (ASD). METHODS:Two reviewers searched PubMed and Clinicaltrials.gov for randomized, double-blind, placebo-controlled trials evaluating the efficacy of SRIs for repetitive behaviors in ASD. Our primary outcome was mean improvement in ratings scales of repetitive behavior. Publication bias was assessed by using a funnel plot, the Egger' s test, and a metaregression of sample size and effect size. RESULTS: Our search identified 5 published and 5 unpublished but completed trials eligible for meta-analysis. Meta-analysis of 5 published and 1 unpublished trial (which provided data) demonstrated a small but significant effect of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.22 [95% confidence interval: 0.07-0.37], z score = 2.87, P , .005). There was significant evidence of publication bias in all analyses. When Duval and Tweedie' s trim and fill method was used to adjust for the effect of publication bias, there was no longer a significant benefit of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.12 [95% confidence interval: -0.02 to 0.27]). Secondary analyses demonstrated no significant effect of type of medication, patient age, method of analysis, trial design, or trial duration on reported SRI efficacy.CONCLUSIONS: Meta-analysis of the published literature suggests a small but significant effect of SRI in the treatment of repetitive behaviors in ASD. This effect may be attributable to selective publication of trial results. Without timely, transparent, and complete disclosure of trial results, it remains difficult to determine the efficacy of available medications. Pediatrics 2012;129:e1301-e1310

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Medication Use in the Management of Comorbidities Among Individuals With Autism Spectrum Disorder From a Large Nationwide Insurance Database

et al. 2021

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Key Points Question How have medications been used recently in the management of symptoms and comorbidities of autism spectrum disorder (ASD)? Findings This population-based cohort study of 26 722 individuals with ASD in the US retrospectively assessed the most common medications used to treat their symptoms and comorbidities during 6 years. Medication type and frequency varied considerably, depending on the comorbidity diagnosed, and individual drug regimens shifted frequently within medication classes over time. Meaning Many individuals with ASD undergo treatment with a wide variety of medications on a trial basis, resulting in frequent changes in drug regimens over time as clinicians attempt to manage associated symptoms and comorbidities.

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Psychotropic Medication Use Among Children With Autism Spectrum Disorders Enrolled in a National Registry, 2007–2008

Cited by 141 publications

References 30 publications

Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders

Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders

Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication Bias

Medication Use in the Management of Comorbidities Among Individuals With Autism Spectrum Disorder From a Large Nationwide Insurance Database

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