Psychotropic Medication Use and Polypharmacy in Children with Autism

Children with autism often take multiple drugs, despite limited evidence about the drugs’ long-term safety

Children with autism often take multiple drugs, despite limited evidence about the drugs’ long-term safety.

Abstract:

Psychotropic medication use and polypharmacy in children with autism spectrum disorders
Children with autism often take multiple drugs, despite limited evidence about the drugs’ long-term safety

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 co-occurring 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 co-occurring conditions. Our results indicate the need to develop standards of care around the prescription of psychotropic medications to children with ASD.

Sources:

Long-Term Use of Paracetamol during Pregnancy may be linked to Autism

Too much Tylenol in pregnancy could affect development

Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled cohort study
International Epidemiological Association, promoting epidemiological research and teaching in all fields of health

Expectant mothers often take Tylenol, with the active ingredient acetaminophen, to deal with back pain, headaches or mild fevers during pregnancy. Is it safe to take Tylenol during pregnancy? This question has been asked by millions of pregnant women. Typically, they hear from their doctor that Tylenol during pregnancy is completely safe for both the mother and her developing baby.

However, a new Norwegian study has found symptoms aligned with autism spectrum disorder (ASD) in Tylenol-exposed children.  Children exposed to long-term use of paracetamol during pregnancy had substantially adverse developmental outcomes at three years of age.

Read Too much Tylenol in pregnancy could affect development
by Kathryn Doyle, 22 Nov 2013

Read Tylenol Use During Pregnancy May be Linked to Autism
by Dr. Brent Hunter, 25 Nov 2013

Sources: Prenatal paracetamol exposure and child neurodevelopment: a sibling-controlled cohort study
International Epidemiological Association, 24 Oct 2013

Tracking the Number of Children identified with Autism Spectrum Disorders

1 in 68 children has been identified with autism spectrum disorder

New Data on Autism Spectrum Disorders
Centers for Disease Control and Prevention – daily credible health and safety updates

More children than ever before – 1 in 68 – are being diagnosed with autism spectrum disorders (ASDs). Track your child’s development and act early if you have a concern. Like the many families living with ASDs, CDC considers ASDs an important public health concern.
CDC is committed to continuing to provide essential data on ASDs, search for risk factors and causes, and develop resources that help identify children with ASDs as early as possible.

Read New Data on Autism Spectrum Disorders, CDC, March 29, 2012.

Could a Pregnant Woman’s Exposure to Drugs alter the Brains of her GrandChildren?

A mom’s crusade could help unravel autism mystery

A mom's crusade could help unravel autism mystery
Could a pregnant woman’s exposure to drugs alter the brains of her grandchildren?

Something a pregnant woman is exposed to may alter not just her children, but also her grandchildren – and possibly even subsequent generations.
The power of pharmaceuticals to do just that came to light with DES, a synthetic estrogen that harmed at least two generations of offspring of women who took it.

Thanks to Jill Escher, scientists are considering how mothers taking fertility drugs in the 1950s and ’60s could be responsible for transgenerational abnormalities:

  • From generation to generation
  • A personal quest
  • Searching the epigenome for answers
  • Antidepressants under the microscope
  • FDA petitioned, NIH involved

Read A mom’s crusade could help unravel autism mystery
MNN Health News, 16 Jul 2013, feat. Jill Autism Exposed interview.

DES DiEthylStilbestrol Resources