Antipsychotic Medication and Risk of Incident Seizure in People with Autism Spectrum Disorder: Analyses with Cohort and Within Individual Study Designs.

The study used primary care records only, so seizures treated in hospital emergency departments or by specialists were not captured, potentially underestimating the true number of seizure events. The analysis did not account for medication dose, which is a known factor in seizure risk; higher doses might carry different risks than the low doses often used for behavioural symptoms in ASD. The study excluded patients with a prior history of epilepsy or seizures, so the results do not apply to that higher-risk subgroup. The analysis treated all antipsychotics as a single group, so it cannot distinguish risks between specific agents like risperidone versus haloperidol. The SCCS analysis included only 149 patients, a small number that limits precision, although the confidence intervals were consistent with the larger cohort.

Ethical approval was obtained from the Scientific Review Committee established to review research using the IMRD-UK database (ref: 18THIN044). No funding sources or conflicts of interest declarations were explicitly stated in the provided text.

Do not interpret the non-significant hazard ratio of 1.28 as proof that antipsychotics are completely safe regarding seizure risk. The study excluded patients with prior epilepsy, did not analyse by dose, and missed hospital-treated seizures, so it cannot rule out increased risk in those specific contexts.