SLPCohortJournal of autism and developmental disorders2020

Psychotropic Medication Prescribing for Neuropsychiatric Comorbidities in Individuals Diagnosed with Autism Spectrum Disorder (ASD) in the UK.

Basmah H Alfageh, Kenneth K C Man, Frank M C Besag and 3 others

PMID 31724119

WHAT IT FOUND

In UK primary care records, 33.4% of people with ASD had at least one psychotropic prescription, and behavioural/conduct disorders, anxiety and ADHD were common.

This describes prescribing, not treatment benefit.

Key findings

016529 patients (33.4%) received at least one psychotropic prescription, and 270,391 psychotropic prescriptions were issued.

0257.3% of the ASD cohort had at least one neuropsychiatric comorbidity; the three most common diagnoses were behavioural/conduct disorders (30.7%), anxiety (15.2%) and ADHD (14.3%).

03The highest numbers of prescriptions were for methylphenidate (46,393), melatonin (38,520) and risperidone (19,800).

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study used primary care records only, so prescriptions from hospitals or specialised centres were not included. Some off-label drugs and controlled drugs may not have been recorded, which could underestimate prescription rates. The database did not link prescriptions to the reason for prescribing, so it cannot show whether medication was used for ASD-related comorbidities. The study could not confirm whether patients took the medication as prescribed. ASD and comorbidity diagnoses were recorded in routine practice, so under-recording or coding differences are possible. The study is descriptive and did not compare outcomes between treated and untreated patients.

The easy way to misread this

Do not conclude that psychotropic medication helped the recorded comorbidities. The study counted prescriptions and diagnoses, did not link drugs to indications, and could not measure adherence or outcomes.

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