Neuropsychiatric profile and psychotropic medication use in adults with autism spectrum disorder: results from the Australian Longitudinal Study of Adults with Autism

Abstract

BackgroundChildren and adolescents with autism spectrum disorder (ASD) are a highly medicated group. Few studies have examined the neuropsychiatric profile and patterns of psychotropic medication use among adults with ASD.AimsTo describe and compare the neuropsychiatric profile and psychotropic medication use in a cohort of adults with ASD and non-autistic controls.MethodBaseline data from a survey-based, longitudinal study of adults with ASD in Australia. Participants were 188 adults with ASD and 115 controls aged 25–80 years.ResultsASD was associated with increased odds of psychotropic medication use even when controlling for the presence of any neurological or psychiatric disorder. There were no corresponding indications for 14.4% of psychotropic medications prescribed to adults with ASD.ConclusionsThis study found substantial psychotropic prescribing for adults with ASD. Patterns of psychotropic medication use may reflect prescribing for behavioural indications despite limited evidence to support this practice.Declaration of interestNone.

Adults with intellectual disability and Attention Deficit Hyperactivity Disorder: Clinical characteristics and medication profiles

“…This may be one of the explanations for the recent findings that 71% of patients with intellectual disability were using psychotropic drugs without a recorded severe mental illness in order to manage their “mood dysregulation” (Sheehan et al, ). These findings were also replicated in a study looking at prescribing in people with autism (Cvejic, Arnold, Foley, & Trollor, ). This is also paralleled by our series where 79% were using antipsychotic medication despite only 3% having a psychotic disorder.…”

Cohort profile: the Australian Longitudinal Study of Adults with Autism (ALSAA)

“…There were high numbers of recruitment responses across the four time 1 survey populations (autistic and control adult self-report, informant report on autistic adults, carer self-report). The ALSAA time 1 data have been used in several studies of psychotropic medication use,75 leisure participation,76 ageing well, 77 loneliness60 and employment 78. ALSAA and SASLA pooled data have been used to explore cognitive reappraisal,79 suicidal ideation,80 psychometric scale validation,64 and anxiety and depression 81.…”

“…Following this protocol, future outputs such as peer-reviewed manuscripts, presentations and reports from the ALSAA will also be developed in consultation with autistic advisors or autistic peer researchers. Input from autistic advisors has already improved the quality and relevance of initial outputs,75 for example, identifying potential alternative interpretations of findings based on lived experiences, potential differences in autistic interpretations of scale items, and modifying the methodology in one instance60 changing a purely quantitative study into a mixed-methods design.…”

Challenging behaviour or untreated ADHD?

“…Adolescents with ID are at significantly higher risk of ADHD than the general population (Reilly and Holland, 2011). There is little evidence regarding the prevalence of ADHD in people with ID but Cvejic et al (2018) reported a higher prevalence rate of ADHD in people with ID compared to studies in the general population. Studies in children with ID have shown a prevalence of ADHD of up to 40 per cent (Baker et al, 2010) but in contrast there is no evidence on the prevalence of ADHD in adults with ID.…”