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Antipsychotic Prescribing Trends in Youths with Autism and Intellectual Disability

Science post imageDate: May 31, 2016

Source: Elsevier

Summary:

About one in 10 youths treated with an antipsychotic are diagnosed with autism spectrum disorder or intellectual disability. Conversely, one in six youths diagnosed with autism spectrum disorder has been prescribed antipsychotics. Furthermore, the results suggest that the proportion of adolescents with autism or intellectual disability has increased among youths treated with antipsychotics and that more youths with autism or intellectual disability have received antipsychotics.

FULL STORY

About one in ten youths treated with an antipsychotic are diagnosed with autism spectrum disorder or intellectual disability. Conversely, one in six youths diagnosed with autism spectrum disorder has been prescribed antipsychotics. These findings are reported in the June 2016 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). Furthermore, the results suggest that the proportion of adolescents with autism or intellectual disability has increased among youths treated with antipsychotics and that more youths with autism or intellectual disability have received antipsychotics.

Currently, second-generation antipsychotics are the only FDA-approved medications for youth with autism. However, these are approved only for the symptomatic control of irritability and aggression. They do not have an indication for youth with intellectual disability, and they do not seem to affect the core symptoms of autism spectrum disorders, 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.

Performing a meta-analysis of 39 studies and over 350,000 youth with mental illness, a group of researchers led by Christoph U. Correll, MD, of Hofstra Northwell School of Medicine, examined the frequency and time trends of antipsychotic prescribing in youth with autism spectrum disorders or intellectual disability, mostly drawing on data from large registry-based studies.

"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," said Correll. "Therefore, 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."

Based on the study results and the known adverse effects of antipsychotics, the authors concluded that clinicians should consider using psychosocial interventions that are proven to be efficient for behavioral dysregulation such as irritability and aggression, before prescribing antipsychotics to adolescents with autism or intellectual disability. The authors further stressed that when prescribing antipsychotics, it is imperative to regularly monitor both their efficacy and tolerability in patients through body weight, fasting lipids and glucose, extrapyramidal side effects, sedation, and sexual/reproductive adverse effects, and to manage abnormalities appropriately.

Story Source:

The above post is reprinted from materials provided by ElsevierNote: Materials may be edited for content and length.

Journal Reference:

  1. Su Young Park, Chiara Cervesi, Britta Galling, Silvia Molteni, Frozan Walyzada, Stephanie H. Ameis, Tobias Gerhard, Mark Olfson, Christoph U. Correll. Antipsychotic Use Trends in Youth With Autism Spectrum Disorder and/or Intellectual Disability: A Meta-AnalysisJournal of the American Academy of Child & Adolescent Psychiatry, 2016; 55 (6): 456 DOI: 1016/j.jaac.2016.03.012

Comments

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Alexandra

When my son was finishing seventh grade (special ed--he's *just on" the spectrum), the school kept pressuring me to get him medicated. He was 13 at the time and autism+puberty=perfect storm.

I said NO. I took him out of the regular school and enrolled him in an Internet-based school. He just finished the 8th grade and is going into the 9th. He's less stressed and doing better. The school adviser said that OHDELA (the Internet school) seemed to be a much better fit for him.

I've also been giving him Behavior Balance (B6, folic acid, B12, and DMG). I started this past week and so far he seems to be less irritable and it looks like his expressive language is improving. His father and I do not believe in medicating kids for behavioral issues.

The old "you'd give your diabetic kid insulin" cracks me up. Our bodies do not produce Ritalin or whatever drug, so bad behavior is not a result of a shortage of some pharmaceutical!

Gary Ogden

Bill: You are entirely correct that psychiatric "diseases" are inventions by highly-educated and -paid people. They make a good bit more than they would writing for publishing houses. Alarming that they are shoving so many drugs into children; I don't believe they did that in my youth in the 50's.

Tim Lundeen

Rimland's book, Dyslogic Syndrome, is superb. He says drugs are the last resort, that they are rarely needed.

Jeannette Bishop

Another area of pharma-care that does its darnedest to to avoid using placebos and valid control groups, prescribes routinely bad things just because there is something bad (sometimes not even then) to treat, they often claim right to remove your right to say no, though they prefer to get your uninformed (and often desperate and trusting) consent, and can often permanently (or some very like) alter your health (and life) for the worse without seeming to notice.

They haven't yet tried mandating "anti"-psychotic additions to our water for general herd (in)sanity, but it seems like it came up somewhere already, and we have anti-depressants already in our water (maybe that was the motivation for the discussion I remember vaguely but can't find--pharma was maybe concerned, maybe unwarrantedly as we're so zombie-like, that they may be required to remediate some of their global environmental pollution )...so maybe they hope that such pollution "saves lives."

 Teresa Conrick

Tom Clancy, Jr./ Bill -

I'm not sure who you are referring to as -- "clinician?" The researchers are putting forth good effort to say that these can be dangerous and to try everything else before even considering them. I commend them for going out on a limb......

The purpose of posting this study, which we are not affiliated with here at AoA, is to educate. Many parents have been told that their child needs to be medicated with this type of drug and here is research showing there is reason to be very cautious, to the point of -

"they do not seem to affect the core symptoms of autism spectrum disorders, 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."

"side effects of antipsychotics can be quite problematic, especially in children and adolescents,"

"clinicians should perform very careful risk: benefit evaluation"

"Based on the study results and the known adverse effects of antipsychotics, the authors concluded that clinicians should consider using psychosocial interventions that are proven to be efficient for behavioral dysregulation such as irritability and aggression, before prescribing antipsychotics to adolescents with autism or intellectual disability."

All best-

Teresa

Bill

There's several very serious problems here, but let's focus on just a couple of them. First, there's a vagueness about the term "antipsychotics". Weren't these DRUGS formerly known as "major tranquilizers"? And, calling *some* of them "2nd generation", or "atypicals" only compounds the confusion and obfuscation. While these DRUGS may APPEAR to have similar effects profiles, user experience has in fact shown a much wider range of effects than most "clinicians" are either aware of, or are willing to acknowledge. And, variabilities in dosage, and other unpredictable variables such as diet, supplements, and idiosyncratic effects further muddy the waters. Another glossed-over FACT is the nebulous, arbitrary, and capricious nature of the alleged "diagnoses" themselves. Clinicians have been brainwashed and indoctrinated to believe that their so-called "mental illness" "diagnoses" have some objective validity - which they DO NOT. So-called "mental illnesses" are exactly as "real" as presents from Santa Claus, but NOT more "real". The DSM-5 should not be regarded as authoritative - it's a catalog of billing codes, and INVENTED, bogus allegations, based on misunderstandings, hubris, and LIES. What a telling report on MASS MEDICAL FRAUD for profit & employment security for "clinicians"! The LIES of the pseudoscience drug racket known as "psychiatry", and PhRMA, in collusion, represents perhaps the gravest on-going Public Health threat the World has ever known. I'd be naive to believe that any clinician will respond to my statements here, but I can always dream, can't I....????....
(c)2016, Tom Clancy, Jr., *NON-fiction

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