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

  • S.I. : Autism Inpatient Collection - Studying the Severely Affected
  • Published:
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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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References

  • Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). The aberrant behavior checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 5, 485–491.

    Google Scholar 

  • Christensen, D. L. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years- autism developmental disabilities monitoring network. Surveillance Summaries 65.

  • Erickson, C. A., Posey, D. J., Stigler, K. A., & McDougle, C. J. (2007). Pharmacologic treatment of autism and related disorders. Pediatric Annals, 36, 575–585.

    Article  PubMed  Google Scholar 

  • Fitzpatrick, S. E., Srivorakiat, L., Wink, L. K., Pedapati, E. V., & Erickson, C. A. (2016). Aggression in autism spectrum disorder: Presentation and treatment options. Neuropsychiatric Disease and Treatment, 12, 1525–1538. doi:10.2147/NDT.S84585.

    Article  PubMed  PubMed Central  Google Scholar 

  • King, B. H., et al. (2009). Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: Citalopram ineffective in children with autism. Archives of General Psychiatry, 66, 583–590. doi:10.1001/archgenpsychiatry.2009.30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P., Risis, S., Gotham, K., & Bishop, S. (2012). Autism diagnostic observation schedule, second edition (ADOS-2). Torrance: Western Psychological Services.

    Google Scholar 

  • Mandell, D. S. (2008). Psychiatric hospitalization among children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38, 1059–1065. doi:10.1007/s10803-007-0481-2.

    Article  PubMed  Google Scholar 

  • Marcus, R. N., et al. (2009). A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 1110–1119. doi:10.1097/CHI.0b013e3181b76658.

    Article  PubMed  Google Scholar 

  • McCracken, J. T., et al. (2002). Risperidone in children with autism and serious behavioral problems. The New England Journal of Medicine, 347, 314–321.

    Article  PubMed  Google Scholar 

  • McElhanon, B. O., McCracken, C., Karpen, S., & Sharp, W. G. (2014). Gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. Pediatrics, 133, 872–883. doi:10.1542/peds.2013-3995.

    Article  PubMed  Google Scholar 

  • McGuire, K., et al. (2015). Psychiatric hospitalization of children with autism or intellectual disability: Consensus statements on best practices. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 969–971. doi:10.1016/j.jaac.2015.08.017.

    Article  PubMed  PubMed Central  Google Scholar 

  • Molloy, C. A., & Manning-Courtney, P. (2003). Prevalence of chronic gastrointestinal symptoms in children with autism and autistic spectrum disorders. Autism, 7, 165–171.

    Article  PubMed  Google Scholar 

  • Owen, R., et al. (2009). Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. Pediatrics, 124, 1533–1540. doi:10.1542/peds.2008-3782.

    Article  PubMed  Google Scholar 

  • Park, S. Y., et al. (2016). Antipsychotic use trends in youth with autism spectrum disorder and/or intellectual disability: A meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 55(456–468), e4. doi:10.1016/j.jaac.2016.03.012.

    Article  Google Scholar 

  • Politte, L. C., Henry, C. A., & McDougle, C. J. (2014). Psychopharmacological interventions in autism spectrum disorder. Harvard Review of Psychiatry, 22, 76–92. doi:10.1097/HRP.0000000000000030.

    Article  PubMed  Google Scholar 

  • Research Units on Pediatric Psychopharmacology Autism Network (2005). Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Arch Gen Psychiatry 62, 1266–1274 doi:10.1001/archpsyc.62.11.1266.

    Article  Google Scholar 

  • Roid, G. H., Miller, L. J., Pomplun, M., Koch, C. (2013). Leiter international performance scale, 3rd Edition. Wood Dail, IL: Stoelting.

    Google Scholar 

  • Rutter, M., Bailey, A., Lord, C. (2003). Social communication questionnaire. Torrance: Western Psychological Services.

    Google Scholar 

  • Saldana, S. N., et al. (2014). Antipsychotic polypharmacy in children and adolescents at discharge from psychiatric hospitalization. Pharmacotherapy, 34, 836–844. doi:10.1002/phar.1453.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schubart, J. R., Camacho, F., & Leslie, D. (2014). Psychotropic medication trends among chidren and adolescents with autism psectrum disorder in the Medicaid program. Autism, 18, 631–637.

    Article  PubMed  Google Scholar 

  • Siegel, M., et al. (2015). The autism inpatient collection: methods and preliminary sample description. Molecular Autism, 6, 61. doi:10.1186/s13229-015-0054-8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Siegel, M., & Gabriels, R. L. (2014). Psychiatric hospital treatment of children with autism and serious behavioral disturbance. Child and Adolescent Psychiatric Clinics of North America, 23, 125–142. doi:10.1016/j.chc.2013.07.004.

    Article  PubMed  Google Scholar 

  • Sparrow, S., Cicchetti, D., Balla, D.A. (2008). Vineland adaptive behaviors scales, 2nd Edition. Livonia: Pearson.

    Google Scholar 

  • Spencer, D., et al. (2013). Psychotropic medication use and polypharmacy in children with autism spectrum disorders. Pediatrics, 132, 833–840. doi:10.1542/peds.2012-3774.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vasa, R. A., et al. (2014). A systematic review of treatments for anxiety in youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44, 3215–3229. doi:10.1007/s10803-014-2184-9.

    Article  PubMed  Google Scholar 

  • Wink, L. K., Erickson, C. A., & McDougle, C. J. (2010). Pharmacologic treatment of behavioral symptoms associated with autism and other pervasive developmental disorders. Current Treatment Options in Neurology, 12, 529–538. doi:10.1007/s11940-010-0091-8.

    Article  PubMed  Google Scholar 

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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.).

Author information

Authors and Affiliations

  1. Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave MLC 4002, Cincinnati, OH, 45229, USA

    Logan K. Wink, Ernest V. Pedapati & Craig A. Erickson

  2. Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave MLC 4002, Cincinnati, OH, 45229, USA

    Ryan Adams

  3. Maine Medical Center Research Institute, Tufts University School of Medicine, 509 Forest Avenue, Portland, ME, 04101, USA

    Kahsi A. Pedersen

  4. Emma Pendleton Bradley Hospital, Rhode Island Consortium for Autism Research and Treatment (RI-CART), and the Hassenfeld Child Health Innovation Institute, Alpert Medical School of Brown University, 1011 Veterans Memorial Pkwy., East Providence, RI, 02915, USA

    Eric M. Morrow

  5. Sheppard Pratt Health System, University of Maryland School of Medicine, 6501 N. Charles Street, Baltimore, MD, 21204, USA

    Desmond Kaplan

  6. Maine Medical Center Research Institute, Spring Harbor Hospital, Tufts University School of Medicine, 123 Andover Road, Westbrook, ME, 04092, USA

    Matthew Siegel

Authors
  1. Logan K. Wink
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  2. Ernest V. Pedapati
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  3. Ryan Adams
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  4. Craig A. Erickson
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  5. Kahsi A. Pedersen
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  6. Eric M. Morrow
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  7. Desmond Kaplan
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  8. Matthew Siegel
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Consortia

for the Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC)

  • Matthew Siegel
  • , Craig Erickson
  • , Robin L. Gabriels
  • , Desmond Kaplan
  • , Carla Mazefsky
  • , Eric M. Morrow
  • , Giulia Righi
  • , Susan L. Santangelo
  • , Logan Wink
  • , Jill Benevides
  • , Carol Beresford
  • , Carrie Best
  • , Katie Bowen
  • , Briar Dechant
  • , Tom Flis
  • , Holly Gastgeb
  • , Angela Geer
  • , Louis Hagopian
  • , Benjamin Handen
  • , Adam Klever
  • , Martin Lubetsky
  • , Kristen MacKenzie
  • , Zenoa Meservy
  • , John McGonigle
  • , Kelly McGuire
  • , Faith McNeil
  • , Joshua Montrenes
  • , Tamara Palka
  • , Ernest Pedapati
  • , Kahsi A. Pedersen
  • , Christine Peura
  • , Joseph Pierri
  • , Christie Rogers
  • , Brad Rossman
  • , Jennifer Ruberg
  • , Elise Sannar
  • , Cathleen Small
  • , Nicole Stuckey
  • , Barbara Tylenda
  • , Mary Verdi
  • , Jessica Vezzoli
  • , Deanna Williams
  • , Diane Williams
  • , Donald L. St. Germain
  • , Girard Robinson
  • , Connie Kasari
  • , Bryan King
  • , James McCracken
  • , Christopher McDougle
  • , Lawrence Scahill
  • , Robert Schultz
  •  & Helen Tager-Flusberg

Corresponding author

Correspondence to Logan K. Wink.

Ethics declarations

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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  • DOI: https://doi.org/10.1007/s10803-017-3153-x

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