Are Doctors Overprescribing Antipsychotics to Young People with Autism?

A new study is suggesting that the number of adolescents with autism or other intellectual disabilities who are being treated with antipsychotics has gone up in recent years.

Researchers at Hofstra Northwell School of Medicine in New York conducted a meta-analysis — a study of studies — that included 39 studies that included more than 350,000 young people with mental illnesses. More specifically, they examined the frequency and when antipsychotics were prescribed to youths with autism or intellectual disability.

About 1 in 6 adolescents diagnosed with autism has been prescribed antipsychotics, with the number increasing, the researchers reported in the Journal of the American Academy of Child & Adolescent Psychiatry. In addition, about 1 in 10 youths treated with an antipsychotic are diagnosed with autism or intellectual disability,

“Although the increased prescribing of antipsychotics in youth with autism spectrum disorders or intellectual disability cannot be judged as appropriate or inappropriate based on database studies, side effects of antipsychotics can be quite problematic, especially in children and adolescents,” lead author Christoph U. Correll, MD, said in a statement.

Second-generation antipsychotics are actually the only FDA-approved medications for the treatment of autism. However, they do not seem to impact the core symptoms of autism, such as social and communication difficulties, or the core symptoms of intellectual disability, such as problems with understanding and responding appropriately to information from the outside world.

The researchers conclude that doctors should consider using psychosocial interventions that are proven to work well for irritability and aggression, before prescribing antipsychotics to adolescents with autism or intellectual disability.

“Clinicians should perform very careful risk: benefit evaluation before and after starting youth with autism spectrum disorders or intellectual disability on an antipsychotic, always trying to maximize non-pharmacologic interventions as well as pharmacologic or non-pharmacologic treatments for comorbidities, including attention-deficit/hyperactivity disorder, anxiety disorders, obsessive-compulsive disorder, and sleep disorders,” Correll noted.

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