Cited by 215Autism Spectrum Disorder ResearchPharmaceutical Practices and Patient OutcomesAttention Deficit Hyperactivity Disorder

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Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders

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Spencer, Donna, Marshall, Jaclyn, Post, Brady, Kulakodlu, Mahesh, Newschaffer, Craig, Dennen, Taylor, Azocar, Francisca, Jain, Anjali·2013·PEDIATRICS

DOI 10.1542/peds.2012-3774PMC PMC3813388

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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 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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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
ORCID: Spencer, Donna
Marshall, Jaclyn
Post, Brady
Newschaffer, Craig
Azocar, Francisca
Jain, Anjali
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
DOI: 10.1542/peds.2012-3774
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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Psychotropic Medication Use and Polypharmacy in Children With Autism Spectrum Disorders

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