Cited by 295Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesAttention Deficit Hyperactivity Disorder

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Psychotropic Medication Use Among Medicaid-Enrolled Children With Autism Spectrum Disorders

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Mandell, David S., Morales, Knashawn H., Marcus, Steven C., Stahmer, Aubyn C., Doshi, Jalpa, Polsky, Daniel E.·2008·Pediatrics

DOI 10.1542/peds.2007-0984PMC PMC2861431

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Abstract

OBJECTIVE: The objective of this study was to provide national estimates of psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders and to examine child and health system characteristics associated with psychotropic medication use. METHODS: This cross-sectional study used Medicaid claims for calendar year 2001 from all 50 states and Washington, DC, to examine 60,641 children with an autism spectrum disorder diagnosis. Logistic regression with random effects was used to examine the child, county, and state factors associated with psychotropic medication use. RESULTS: Of the sample, 56% used at least 1 psychotropic medication, 20% of whom were prescribed > or = 3 medications concurrently. Use was common even in children aged 0 to 2 years (18%) and 3 to 5 years (32%). Neuroleptic drugs were the most common psychotropic class (31%), followed by antidepressants (25%) and stimulants (22%). In adjusted analyses, male, older, and white children; those who were in foster care or in the Medicaid disability category; those who received additional psychiatric diagnoses; and those who used more autism spectrum disorder services were more likely to have used psychotropic drugs. Children who had a diagnosis of autistic disorder or who lived in counties with a lower percentage of white residents or greater urban density were less likely to use such medications. CONCLUSIONS: Psychotropic medication use is common among even very young children with autism spectrum disorders. Factors unrelated to clinical presentation seem highly associated with prescribing practices. Given the limited evidence base, there is an urgent need to assess the risks, benefits, and costs of medication use and understand the local and national policies that affect medication use.

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Authors: Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E.
Affiliations: Leonard Davis Institute of Health Economics (US)
University of Pennsylvania (US)
Rady Children's Hospital-San Diego (US)
ORCID: Mandell, David S.
Morales, Knashawn H.
Marcus, Steven C.
Stahmer, Aubyn C.
Doshi, Jalpa
Polsky, Daniel E.
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2008-03-01
Volume: 121
Issue: 3
Pages: e441-e448
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2007-0984
PMC: PMC2861431
OpenAlex: W1980023413
Cited by: 295
References: 49
Citations by year: 2026: 2 · 2025: 17 · 2024: 17 · 2023: 14 · 2022: 20 · 2021: 21 · 2020: 16 · 2019: 16 · 2018: 19 · 2017: 14 · 2016: 19 · 2015: 15 · 2014: 16 · 2013: 35 · 2012: 18
FWCI: 6.22
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: University of Pennsylvania
National Institute of Mental Health (R01MH077000)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Keywords: psychotropic drug use, autism spectrum disorder, Medicaid, children, antipsychotic drugs, antidepressants, stimulants, prescribing patterns, foster care, county-level factors, racial and ethnic disparities, urban density
MeSH terms: Adolescent, Age Factors, Attitude of Health Personnel, Autistic Disorder, Mental Disorders, Child, Child, Preschool, Cross-Sectional Studies, Drug Utilization, Eligibility Determination, Female, Follow-Up Studies, Humans, Male, Medicaid, Practice Patterns, Physicians', Probability, Psychotropic Drugs, Retrospective Studies, Sex Factors, Multicenter Studies as Topic, Incidence, Multivariate Analysis, Treatment Outcome, Risk Assessment, Asperger Syndrome

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Psychotropic Medication Use Among Medicaid-Enrolled Children With Autism Spectrum Disorders

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