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

Abstract

Autism spectrum disorder (ASD) is a lifelong disorder. In the UK, risperidone is the only psychotropic medication approved for the management of the behavioural symptoms that may accompany autism. This is a population-based study aimed to provide an evaluation of the changing trend in the incidence and prevalence of ASD and to analyse the pattern of psychotropic medication prescribing in the UK. 20,194 patients with ASD were identified. The prevalence increased 3.3-fold from 0.109 per 100 persons in 2009 to 0.355 per 100 persons in 2016. Approximately one-third of the identified cohort was prescribed at least one psychotropic medication. Although the medications approved to manage the symptoms of ASD are limited, the prescribing of such medications is increasing.

Autism spectrum disorder (ASD) is a persistent neurodevelopmental condition characterised by social communication impairment and stereotyped, repetitive patterns of behaviour (APA 2013). A previous study in the United Kingdom (UK) using electronic primary care data showed that the incidence rate of pervasive developmental disorders (PDDs) increased from 0.40/10,000 (95% CI 0.30–0.54) to 2.98/10,000 (95% CI 2.56–3.47) person-years between 1991 and 2001 (Smeeth et al. 2004b). Another study showed that 70% of 112 children with autism had at least one neuropsychiatric comorbid disorder, of which the most common diagnosis was social anxiety disorder (29.2%; 95% CI 13.2–45.1) (Simonoff et al. 2008).

Psychotropic medications, such as antipsychotics, antidepressants, antiepileptic drugs and stimulants, have been used for ASD patients with associated comorbid conditions (National Collaborating Centre for Mental Health 2012). There is, however, limited evidence to guide psychotropic medication prescribing in the ASD population. Risperidone is the only drug approved by the European Medicines Agency (EMA), the Medicines and Healthcare Products Regulatory Agency (MHRA) of the UK, and the Australian Therapeutic Goods Administration (TGA) for the management of behavioural disturbance in children and adolescents with autism and conduct disorder (European Medicines Agency 2007; World Health Organisation 2013).

ASD can lead to impairment of the quality of life and the productivity of affected persons and their families; therefore, ASD and its complications have a significant impact on society and the individual, which should not be ignored. The aim of this study was to provide up-to-date information on the prevalence of ASD, psychiatric comorbidities and psychotropic medication prescribing in a UK population sample with individuals from all ages. We also aimed to examine the average duration of psychotropic treatment in treated patients.