Use of psychotropic drugs in patients with autism spectrum disorders: a systematic review

Acta Psychiatr Scand. 2017 Jan;135(1):8-28. doi: 10.1111/acps.12644. Epub 2016 Sep 13.

Abstract

Objective: The objective of this review was to examine prevalence and patterns of psychopharmacotherapy in individuals with autism spectrum disorder (ASD).

Method: A systematic literature search in PubMed, CINAHL, and PsycINFO was performed, including articles published up to November 18, 2015.

Results: A total of 47 studies (data collection: 1976-2012), encompassing >300 000 individuals with ASD, were included. The prevalence of psychopharmacotherapy ranged from 2.7% to 80% (median (overall): 45.7%; median (children): 41.9%; median (adults): 61.5%), with psychotropic polypharmacy occurring in 5.4-54% (median: 23.0%). Regarding drug classes, antipsychotics were most frequently used, followed by attention-deficit/hyperactivity disorder (ADHD) medication and antidepressants. Both older age and psychiatric comorbidity were associated with higher prevalences of psychopharmacotherapy and psychotropic polypharmacy. There were no time trends in psychopharmacotherapy prevalence observable.

Conclusion: Despite a lack of pharmacological treatment options for ASD core symptoms, the prevalence of psychopharmacotherapy and polypharmacy in ASD patients is considerable, which is probably due to the treatment of non-core ASD symptoms and psychiatric comorbidities. While there is some evidence for the use of antipsychotics and ADHD medication for these indications, the use of antidepressants should be limited to selected cases.

Keywords: autism spectrum disorder; drug-therapy; polypharmacy; prevalence; psychotropic drugs.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Autism Spectrum Disorder / drug therapy*
  • Child
  • Female
  • Humans
  • Male
  • Polypharmacy
  • Prevalence
  • Psychotropic Drugs / classification*
  • Psychotropic Drugs / therapeutic use*

Substances

  • Psychotropic Drugs