Epilepsy in adulthood: Prevalence, incidence, and associated antiepileptic drug use in autistic adults in a state Medicaid system.
Lauren Bishop, Kiley J McLean, Eric Rubenstein
PMID 32757616WHAT IT FOUND
Epilepsy is highly prevalent in autistic adults, especially those with intellectual disability.
Many autistic adults on antiepileptic drugs lack epilepsy diagnoses, suggesting off-label use for behavior. Clinicians should screen for epilepsy in aging autistic adults with ID.
Key findings
01The 11-year prevalence of epilepsy was 34.6 per 100 in autistic adults with ID, compared to 11.1 per 100 in autistic adults without ID.
02A majority of autistic adults without ID (80.3%) who received antiepileptic medications did not have a medical claim for epilepsy, indicating frequent off-label prescribing.
03Incidence of epilepsy was highest in autistic adults without ID aged 40-49, while incidence increased after age 50 in those with ID.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Diagnoses were based on claims data and not validated by standardized clinical exams, so inaccuracies are possible. The study only included adults eligible for Medicaid, potentially excluding autistic adults who are not formally diagnosed or do not meet income criteria. Race data was missing for many participants, limiting the ability to assess disparities by race. Pharmacy claims could not be matched to specific medical claims by date, making it difficult to determine if a prescription was for epilepsy or another condition.
The easy way to misread this
Do not assume a patient is taking antiepileptic medication for epilepsy. Most autistic adults without ID on these drugs had no epilepsy diagnosis, indicating off-label use for behavior or mental health.