Caroline Croteau Laurent Mottron, Dr Nancy Presse Jean-Eric Tarride Marc Dorais Sylvie Perreault


Background: Psychoactive medications are commonly prescribed to autistic individuals, but little is known about how their use changes after diagnosis.

Objectives: This study describes the use of psychoactive drugs in children and young adults newly diagnosed with autism spectrum disorder (ASD), between the year before and up to 5 years after diagnosis.

Methods: Multivariable logistic regression was used to examine the relationship between the use psychoactive drugs before the first ASD diagnosis (from 1998 to 2010), and the clinical and demographic characteristics, identified from public healthcare databases in Quebec. The types of drugs prescribed and psychoactive polypharmacy were evaluated over five years of follow-up. Generalized estimating equations (GEE) were used to examine the association of age and time with the use of psychoactive drugs.

Results: In our cohort of 2,989 individuals, diagnosis of another psychiatric disorder before ASD strongly predicted psychoactive drug use. We observed that the proportion of users of psychoactive drugs increased from 35.6% the year before, to 53.2% five years after the ASD diagnosis. Psychoactive polypharmacy (≥2 psychoactive drug classes) also increased from 9% to 22% in that time. Age and time since diagnosis strongly associated with the types and combinations of psychoactive drugs prescribed.

Conclusion: Psychoactive drug use and polypharmacy increases substantially over time after ASD diagnosis in children and could be of concern if used in lieu of other treatment modalities.