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Psychopharmacological prescriptions for people with autism spectrum disorder (ASD): a multinational study

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Abstract

Rationale

Previous studies on psychotropic drugs prescribing in autism spectrum disorder (ASD) were from the USA or the UK. However, these studies may not be generalizable to other countries. There is a need to understand the extent of psychopharmacological prescribing for ASD treatment at a multinational level to identify areas of prescribing which lack evidence.

Methods

We used the IMS Prescribing Insights database to investigate psychotropic drugs prescribing patterns for ASD treatment in children and adults in 2010–2012. Data were obtained from Europe (France, Germany, Italy, Spain and UK), South America (Mexico and Brazil), North America (Canada and USA) and Asia (Japan).

Results

North American countries have the highest prescription rates, followed by the European and South American countries. Prescribing rates were higher in children compared to adults in individual countries. The most commonly prescribed drug for ASD was risperidone in young people (except in UK and Japan). In the UK, methylphenidate (34 %) was the most commonly prescribed for young people and haloperidol (44.1 %) in Japan. In adults, the most commonly prescribed drug class was antipsychotics and particularly risperidone (thioridazine and ziprasidone were the most prescribed antipsychotics in Brazil and USA, respectively).

Conclusion

There is variation in medication prescription for people with ASD among countries, which may be attributable to diagnostic criteria, clinical guidelines or health care systems. However, there is a lack of evidence of efficacy and safety for many psychotropic drugs prescribed for people with ASD. Research is needed to bridge the evidence gaps in prescribing.

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Acknowledgements

The research leading to these results has received support from the Innovative Medicines Initiative (IMI) Joint Undertaking under grant agreement no. 115300: European Autism Interventions (EU-AIMS), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies in kind contribution. DM, IW and ES also received funding from the National Institute of Health Research (UK) for a program grant on this topic and for the neurodevelopmental theme in Biomedical Research Centre at the Institute of Psychiatry, London, UK.

Conflicts of interest

ES, YH and AW have no conflicts of interest. DGM has received research funding and honoraria from various pharmaceutical companies, including Shire and Janssen-Cilag. He is currently receiving funding from the IMI for EU-AIMS to identify new treatment targets for ASD. JB has been in the past 3 years a consultant to/member of advisory board of/and/or speaker for Janssen Cilag BV, Eli Lilly, Shire, Novartis, Roche and Servier. He is not an employee of any of these companies and not a stock shareholder of any of these companies. He has no other financial or material support, including expert testimony, patents and royalties. He is currently receiving funding from the European Union's Seventh Framework Programme to investigate the safety of risperidone in children (PERS), the long-term safety of methylphenidate (ADDUCE) and EU-AIMS to identify new treatment targets for ASD. IW has received research funding and honoraria from various pharmaceutical companies, including Shire, Janssen-Cilag and Bristol-Myers Squibb. He is currently receiving funding from the European Union's Seventh Framework Programme to investigate the safety of risperidone in children (PERS) and the long-term safety of methylphenidate (ADDUCE). He is also a director of Healthcare Innovation Technology Service Limited, which received funding from the IMI for taking part in the EU-AIMS project. DM currently receives research funding from Shire, and in the past has received honoraria from Janssen-Cilag and Wyeth.

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Correspondence to Ian C. K. Wong.

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Hsia, Y., Wong, A.Y.S., Murphy, D.G.M. et al. Psychopharmacological prescriptions for people with autism spectrum disorder (ASD): a multinational study. Psychopharmacology 231, 999–1009 (2014). https://doi.org/10.1007/s00213-013-3263-x

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