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Study Finds that Many Kids With Autism are on Multiple Medications

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It is common practice that children in the United States that have been diagnosed with autism ( PDD - pervasive developmental disorders ), often take one or more prescription medications. But did you know that there is little or no evidence that exists confirming the effectiveness for treating the neuro developmental condition? The new study found that although many kids with autism take these medications, there is not much proof that it is treating their PDD.

The study of almost 34000 children with an autism spectrum disorder found nearly 2/3rds were prescribed at least 1 medication. Within that group, more than 1/3rd were given 2 medications, and 1 out of 7 took 3 drugs.
The U.S. Centers for Disease Control and Prevention has more about treatment for kids with autism.

“There are a lot of children who are being treated with psychotropic medications with unknown effects for benefits and harms,” a comment from the study’s senior author, Dr. Anjali Jain, a managing consultant with the Falls Church, Virginia based Lewin Group, a health care consulting firm.

Dr. Anjali Jain also said “I hope everyone — parents and providers of children with autism – will consider these  PDD medications with caution”.

The study, released online Oct. 21 in Pediatrics, looked at the use of psychotropic medications, which includes seizure medications, antidepressants, antipsychotics, attention-deficit/hyperactivity disorder (ADHD) drugs, lithium (a drug that treats manic behavior), and Parkinson’s drugs for kids and young adults with autism. The more commonly prescribed medications were antidepressants, antipsychotics and ADHD drugs, or combinations of them, Jain said.

In the United States alone, there are about 1 in  88 children that have been diagnosed with an autism spectrum disorder. These cases of autism can range from mild, as in Asperger syndrome, to severe autism. Children with autism have impaired communication and social skills, and often exhibit repetitive behaviors.

Many of the medications that are prescribed, are done so for other, co-existing disorders, such as depression or ADHD. This can cause a problem in people with autism, “When diagnosing and attempting to treat these disorders, it can be really hard to disentangle which behavior goes with which disorder,” said Jain.

Treatments based upon behavior, perhaps including parent training, are generally the 1st line of therapy for children with autism spectrum disorders. But because children with autism are such a varied group, “It is hard to come up with a treatment that covers every child,” Jain said.

Dr. Paul Wang, senior vice president of medical research for Autism Speaks, an autism advocacy organization, agreed. “It’s challenging to diagnose a person within the context of an autism spectrum disorder,” Dr Wang said. “They can not always tell you if they are anxious or depressed. And if they are not paying attention, is that a sign of ADD or are they fixated on something else due to the autism spectrum disorder?”

It is also possible that something entirely unrelated is aggravating symptoms, Wang added. “Some of these autistic kids may not have been thoroughly evaluated for a physical condition. You may have a child with an earache who cannot express what is going on, and that might manifest as irritable or aggressive behavior,” Wang noted.

The only medications currently approved by the USFDA ( U.S. Food and Drug Administration ) to treat autism spectrum disorders are risperidone ( Risperdal ) and aripiprazole ( Abilify ), antipsychotics that are prescribed for treating irritability and aggression. Other medications can be prescribed in what’s known as an “off-label” use. However, that means there is likely little information on how they might affect someone with autism or on possible side effects.

The current study points to a need for more research into the effects these drugs have on children with autism, Jain and Wang said.

In this autism medication study, the researchers examined data on 33565 children and young adults that were 20 years old and under, that had been previously diagnosed with an autism spectrum disorder. The data was insured through a large commercial insurer in the United States.

64% of the children in the study had at least 1 prescription filled for a psychotropic medication. 35% of the children had prescriptions filled for 2 or more psychotropic medications, and 15% had prescriptions for 3 or more psychotropic drugs concurrently.

The study found that older children that had seen a psychiatrist & those diagnosed with an additional condition, such as seizures or depression, were more likely to have been prescribed 1 or more psychotropic medications.

“The study could not tell why older children were more likely to receive psychotropic medication, but one reason could be that the doctor’s comfort level with medication in older children is greater,” Dr Jain said.

“Another potential reason is that doctors may have started a younger child on behavioral therapy that has not worked for every symptom, and now they want to try medications for the remaining symptoms,” Jain also said.

Another potential reason is that behaviors in an older child might become harder to manage, the experts suggested. “A challenging behavior in a big teenage boy with an autism spectrum disorder will make a parent and a doctor more willing to try medication than the same behavior in a smaller autistic child,” said Dr Wang.

The study proves that more research is needed when prescribing medication for Autism, and a better way of determining which symptoms are part of which disorder.

February 16, 2014 |

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