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Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders
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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.
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“Studies have reported high rates of polypharmacy ranging from 12 to 35% based on the type of studies [28, 29].”
From An Update on Psychopharmacological Treatment of Autism Spectrum Disorder (2022) · cites this paper as [29]
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“This estimate is higher than reports from prior longitudinal studies in solely pediatric populations with ASD.”
From Medication use in the management of comorbidities among individuals with autism spectrum disorder from a large nationwide insurance database (2021) · cites this paper as [47]
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High School Students on The Autism Spectrum
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Metadata
- Authors
- Spencer, D., Marshall, J., Post, B., Kulakodlu, M., Newschaffer, C., Dennen, T., Azocar, F., & Jain, A.
- Affiliations
- Optum (United States) (US)
- Lewin Group (United States) (US)
- Drexel University (US)
- OptumHealth Behavioral Solutions, San Francisco, California
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2013-11-01
- Volume
- 132
- Issue
- 5
- Pages
- 833-840
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3813388
- OpenAlex
- W2153868538
- Cited by
- 215
- References
- 29
- Citations by year
- 2026: 10 · 2025: 16 · 2024: 17 · 2023: 14 · 2022: 21 · 2021: 24 · 2020: 20 · 2019: 16 · 2018: 17 · 2017: 18 · 2016: 19 · 2015: 17 · 2014: 5
- FWCI
- 7.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PEDIATRICS (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Keywords
- autism spectrum disorder, psychotropic drugs, polypharmacy, children, comorbidities, psychiatric comorbidity, prescribing patterns, standard of care
- MeSH terms
- Adolescent, Child, Child Development Disorders, Pervasive, Child, Preschool, Female, Humans, Infant, Male, Psychotropic Drugs, Retrospective Studies, Polypharmacy, Young Adult
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