A large new study finds that more than half of children and teens with autism have been prescribed psychoactive medicine, and over a third have been prescribed two or more at one time. The majority of the children taking the medications had additional conditions that frequently occur with autism. These included seizures, bipolar disorder, depression, anxiety and attention deficit disorders.
The study appears today in the journal Pediatrics. It largely concurs with a smaller study of mostly younger children published last year by specialists in the Autism Speaks Autism Treatment Network (AS-ATN).
The new study was sponsored by the National Institute of Mental Health. Most of its authors work for UnitedHealth Group, which operates the medical insurer UnitedHealthcare. This enabled them to analyze the anonymous health-coverage records for 33,565 children and teens with a diagnosis of autism spectrum disorder (ASD). On average, the children’s records spanned three to four years.
Call for standards of care
The authors go on to express concern about a general lack of evidence on the safety and effectiveness of these medications in children with autism. Currently, the only FDA-approved medicines specifically for children with autism are risperidone and aripiprazole. Both treat autism-associated irritability including aggression. The researchers call for the development of clear standards for the use of other psychoactive medicines in children with ASD.
“Doctors are trying to help their patients with whatever treatments are available,” comments developmental-behavioral pediatrician Paul Wang, Autism Speaks vice president for medical research. (Dr. Wang was not involved in the study.) “Autism Speaks has long supported the development of guidelines to help doctors in their decisions on medication use,” he says.
Autism Speaks network pioneers guidelines
Last year, Pediatrics published a special supplement with guidelines developed by specialists in the AS-ATN, through the network’s role as the federally funded Autism Intervention Research Network on Physical Health (AIR-P). These included best practices for the consideration and use of medicines for attention deficit and hyperactivity disorder (ADHD) in children with autism. (Read the full report here.)
Autism Speaks has also created tool kits to help parents work with their physicians in deciding whether psychoactive medicines are right for their children and how to safely use them if they decide to do so. (Download the ATN/AIR-P Medication Decision Aid here. Download ATN/AIR-P Autism and Medication: Safe and Careful Use here.)
“Our clinicians agree on the need for better evidence of the effectiveness of these medications in those with autism and for better practice guidelines,” says AS-ATN medical director Dan Coury. Currently, the Autism Speaks network is developing recommendations for the treatment of anxiety and irritability/agitation.
“None of the currently available medications was developed specifically for autism,” Dr. Wang adds. “In the longer term, what we really need are new treatments tailored specifically for ASD that help address its core deficits.”
Autism Speaks is currently funding research into more effective treatments – including medicines – for autism and its associated medical conditions. You can read more about these grants and all Autism Speaks-funded research using this website’s Grant Search.