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Characterization of Medication Use in a Multicenter Sample of Pediatric Inpatients with Autism Spectrum Disorder

Abstract

Nearly 11% of youth with Autism Spectrum Disorder (ASD) undergo psychiatric hospitalization, and 65% are treated with psychotropic medication. Here we characterize psychotropic medication usage in subjects enrolled in the Autism Inpatient Collection. Participant psychotropic medication usage rates topped 90% at admission and discharge, though there was a decline at 2-month follow-up. Antipsychotics, ADHD medications, and sleep aids were the most commonly reported classes of medications. The impact of age, gender, and non-verbal IQ on medication usage rates was minimal, though age and IQ may play a role in prescribing practices. Future work is indicated to explore medication usage trends, the impact of clinical factors on medication use rates, and the safety of psychotropic medications in youth with ASD.

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Acknowledgments

The ADDIRC is made up of these co-investigators: Matthew Siegel, MD (PI) (Maine Medical Center Research Institute; Tufts University), Craig Erickson, MD (Cincinnati Children’s Hospital; University of Cincinnati), Robin L. Gabriels, PsyD (Children’s Hospital Colorado; University of Colorado), Desmond Kaplan, MD (Sheppard Pratt Health System), Carla Mazefsky, PhD (Western Psychiatric Institute and Clinics; University of Pittsburgh), Eric M. Morrow, MD, PhD (Bradley Hospital; Brown University), Giulia Righi, PhD (Bradley Hospital; Brown University), Susan L Santangelo, ScD (Maine Medical Center Research Institute; Tufts University), and Logan Wink, MD (Cincinnati Children’s Hospital; University of Cincinnati). Collaborating investigators and staff: Jill Benevides, BS, Carol Beresford, MD, Carrie Best, MPH, Katie Bowen, LCSW, Briar Dechant, BS, Tom Flis, BCBA, LCPC, Holly Gastgeb, PhD, Angela Geer, BS, Louis Hagopian, PhD, Benjamin Handen, PhD, BCBA-D, Adam Klever, BS, Martin Lubetsky, MD, Kristen MacKenzie, BS, Zenoa Meservy, MD, John McGonigle, PhD, Kelly McGuire, MD, Faith McNeil, BS, Joshua Montrenes, BS, Tamara Palka, MD, Ernest Pedapati, MD, Kahsi A. Pedersen, PhD, Christine Peura, BA, Joseph Pierri, MD, Christie Rogers, MS, CCC-SLP, Brad Rossman, MA, Jennifer Ruberg, LISW, Elise Sannar, MD, Cathleen Small, PhD Nicole Stuckey, MSN, RN, Barbara Tylenda, PhD, Mary Verdi, MA, Jessica Vezzoli, BS, Deanna Williams, BA, and Diane Williams, PhD, CCC-SLP. We gratefully acknowledge the contributions of the coordinating site advisory group: Donald L. St. Germain, MD and Girard Robinson, MD, and our scientific advisory group: Connie Kasari, PhD., Bryan King, MD, James McCracken, MD, Christopher McDougle, MD, Lawrence Scahill, MSN, PhD, Robert Schultz, PhD and Helen Tager-Flusberg, PhD, the input of the funding organizations and the families and children who participated.

Author Contributions

LW participated in acquisition of the data, drafting and revision of the manuscript, and approval of the final draft. EP, CE, EM, and DK participated in acquisition of the data, revision of the manuscript, and approval of the final draft. RA and KP completed statistical analysis of the data, participated in drafting and revision of the manuscript, and approved the final draft. MS participated in conception and design of the study, revision of the manuscript, and approval of the final draft.

Funding

The Autism Inpatient Collection (AIC) phenotypic database and biorepository is supported by a grant from the Simons Foundation Autism Research Initiative and the Nancy Lurie Marks Family Foundation, (SFARI #296318 to M.S.).

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Correspondence to Logan K. Wink.

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Conflict of interest

The authors report no direct conflicts of interest with this report. Dr. Wink’s current research is supported by the Simons Research Foundation, Autism Speaks, Riovant Sciences Ltd, and Cures Within Reach. Dr. Pedapati receives research support from the Cincinnati Children’s Hospital Research Foundation. Dr. Erickson is a consultant to and holds equity in Confluence Pharmaceuticals and is a consultant to Neurotrope and Fulcrum. Dr. Erickson is a past consultant to Alcobra Pharmaceuticals, the Roche Group, and Novartis. Dr. Erickson holds non-related IP held by CCHMC and Indiana University. Dr. Erickson receives or has received research grant support from the John Merck Fund, Indiana University School of Medicine, Cincinnati Children’s Hospital Medical Center, Autism Speaks, the United States Department of Defense, the Simons Foundation, the United States Centers for Disease Control, the National Fragile X Foundation, The Roche Group, Neuren Pharmaceuticals, the National Institutes of Health, and Riovant Sciences Ltd. Dr. Morrow is supported by the National Institute of Mental Health (R01 MH105442) and a grant from the Simons Foundation Autism Research Initiative (SFARI #286756 to EMM). Dr. Kaplan and Dr. Siegel report no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This project was approved by the Institutional Review Boards at each of the ADDIRC sites participating in the AIC.

Informed Consent

Guardians of all participants provided written informed consent prior to enrolling in the project.

Additional information

The members of ADDIRC are listed in Acknowledgments section.

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Wink, L.K., Pedapati, E.V., Adams, R. et al. Characterization of Medication Use in a Multicenter Sample of Pediatric Inpatients with Autism Spectrum Disorder. J Autism Dev Disord 48, 3711–3719 (2018). https://doi.org/10.1007/s10803-017-3153-x

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Keywords

  • Autism
  • Autism Spectrum Disorder
  • Medication
  • Antipsychotics
  • Psychiatric hospitalization