INCIDENCE OF PSYCHOTROPIC DRUGS PRESCRIBED IN CHILDREN AND ADOLESCENTS WITH AUTISM AT EL. TEGANI-ALMAHI REFERENCE HOSPITAL KHARTOUM SUDAN. A CROSS-SECTIONAL STUDY.
DOI:
https://doi.org/10.51168/sjhrafrica.v5i12.1457Keywords:
Autism, Psychotropic, Drugs, Epilepsy, Psychiatric disorder, mental health, prevalence, prescriptionAbstract
Background:
Autism spectrum disorder (ASD) among vulnerable populations frequently presents with complex mental health diagnoses, and psychotropic medications are often a component of comprehensive biopsychosocial treatment plans for these conditions. The primary aim of this study is to determine the incidence of usage of psychotropic drugs and to assess the response of psychotropic medications prescribed in children and adolescents with autism in a resource-constrained setting in Khartoum Sudan.
Materials and methods:
Following an institutional review board approval, Department of Innovation, Development and Scientific Research, Ministry of Health, Khartoum State (IDSREC-2020-EATA/44/A), A cross-sectional retrospective hospital-based study was conducted from January 2018 to Jan-2021 among 261 children and adolescents aged 1 to 17 years diagnosed with ASD using The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) as a guideline. SPSS version 25.
Results:
The prevalence of ASD was greater in males than females; 45% of autistic patients have at least one comorbid disease. Attention Deficit Hyperactivity Disorder (ADHD), learning disability (LD), and epilepsy are the three most comorbid diseases among autistic patients. The Average number of psychotropic drugs per prescription was 1.8 out of 2.61. The most often prescribed medications among this group were risperidone (49%), methylphenidate (33%), and valproic acid (15%). All the patients received at least one psychotropic prescription; 30% of the patients were receiving polytherapy. Non-adherence of the patient to their medication account for 24%. This indicated the efficacy of other treatment approaches and the importance of combining medication and non-medication therapy.
Conclusion:
The study revealed a significant use of psychotropic medication, with a notable emphasis on antipsychotics. There is a high incidence of prescription rates for psychotropic medications for comorbid psychiatric disorders.
References
Persico AM, Ricciardello A, Lamberti M, Turriziani L, Cucinotta F, Brogna C, Vitiello B, Arango C. The pediatric psychopharmacology of autism spectrum disorder: A systematic review - Part I: The past and the present. Prog Neuropsychopharmacol Biol Psychiatry. 2021 Aug30https://doi.org/10.1016/j.pnpbp.2021.110326
https://www.mayoclinic.org/diseases-conditions/autism-spectrum disorder / symptoms-causes/sync-20352928
Wakefield's affair: 12 years of uncertainty whereas no link between autism and MMR vaccine has been proved. Maisonneuve H, Floret D. Presse Med. 2012 Sep; French (https://www.ncbi.nlm.nih.gov/pubmed/22748860).
Steinhausen HC: Recent international trends in psychotropic medication prescriptions for children and adolescents. Eur Child Adolesc Psychiatry. 2015, https://doi.org/10.1007/s00787-014-0631-y
Louw, K.-A.; Bentley, J.; Sorsdahl, K.; Adnams, C.M. Prevalence and patterns of medication use in children and adolescents with autism spectrum disorders in the Western Cape, South Africa. J. Child Adolesc. Ment. Health 2013, 25, 69-79. [CrossRef] https://doi.org/10.2989/17280583.2013.767265
Farmer CA, Aman MG. Aripiprazole for the treatment of irritability associated with autism. Expert Opin Pharmacother 2011; 12: 635-40. https://doi.org/10.1517/14656566.2011.557661
Scott LJ, Dhillon S. Risperidone: a review of its use in the treatment of irritability associated with autistic disorder in children and adolescents. Pae diatr Drugs 2007; 9: 343-54. https://doi.org/10.2165/00148581-200709050-00006
Oswald DP, Sonenklar NA. Medication use among children with autism spectrum disorders. J Child Adolesc Psychopharmacol 2007; 17: 348-55. https://doi.org/10.1089/cap.2006.17303
Rosenberg RE, Mandell DS, Farmer JE, Law JK, Marvin AR, Law PA. Psychotropic medication use among children with autism spectrum disorders enrolled in a national registry, 2007-2008. J Autism Dev Disord 2010; 40: 342-51. https://doi.org/10.1007/s10803-009-0878-1
Procyshyn RM, Bezchlibnyk-Butler KZ, Kim DD: Clinical Handbook of Psychotropic Drugs. Hogrefe Publishing, Newburyport, MA; 2023. https://doi.org/10.1027/00632-000
Zanarini MC, Frankenburg FR, Bradford Reich D, Harned AL, Fitzmaurice GM: Rates of psychotropic medication use reported by borderline patients and axis II comparison subjects over 16 years of prospective follow-up. J Clin Psychopharmacol. 2015, 35:63-7. https://doi.org/10.1097/JCP.0000000000000232
Puspitasari IM, Sinuraya RK, Rahayu C, et al.: Medication profile and treatment cost estimation among outpatients with schizophrenia, bipolar disorder, depression, and anxiety disorders in Indonesia. Neuropsychiatr Dis Treat. 2020, 16:815-28. 10.2147/NDT.S240058 https://doi.org/10.2147/NDT.S240058
Wisner KL, Schaefer C: Psychotropic drugs. Drugs during Pregnancy and Lactation: Treatment Options and Risk Assessment. Schaefer C, Peters P, Miller RK (ed): Academic Press, Cambridge, MA; 2015. 293-339. https://doi.org/10.1016/B978-0-12-408078-2.00012-3
Young, N.; Findling, R.L. An update on pharmacotherapy for autism spectrum disorder in children and adolescents. Curr. Opin. Psychiatry 2015, 1. [CrossRef] [PubMed]
Earle, J.F. An introduction to the psychopharmacology of children and adolescents with autism spectrum disorder. J. Child Adolesc. Psychiatr. Nurs. 2016, 29, 62-71. [CrossRef] [PubMed] https://doi.org/10.1111/jcap.12144
Howes, O.D.; Rogdaki, M.; Findon, J.L.; Wichers, R.H.; Charman, T.; King, B.H.; Loth, E.; McAlonan, G.M.; McCracken, J.T.; Parr, J.R.; et al. autism spectrum disorder: Consensus guidelines on assessment, treatment, and research from the British Association for Psychopharmacology. J. Psychopharmacol. (Oxf.) 2018, 32, 3-29. [CrossRef] [PubMed] https://doi.org/10.1177/0269881117741766
Bachmann CJ, Manthey T, Kamp-Becker I, Glaeske G, Hoffmann F. Psy chopharmacological treatment in children and adolescents with autism spectrum disorders in Germany. Res Dev Disabil 2013; 34: 2551-63. https://doi.org/10.1016/j.ridd.2013.05.028
Khanna R, Jariwala K, West-Strum D. Use and cost of psychotropic drugs among recipients with autism in a state Medicaid fee-for-service program. J Intellect Disabil Res 2013; 57: 161-71. https://doi.org/10.1111/j.1365-2788.2012.01563.x
Jobski, K.; Höfer, J.; Hoffmann, F.; Bachmann, C. Use of psychotropic drugs in patients with autism spectrum disorders: A systematic review. Acta Psychiatr. Scand. 2017, 135, 8-28. [CrossRef] [PubMed] https://doi.org/10.1111/acps.12644
https://my.clevelandclinic.org/health/diseases/8855-autism
Memari AH, Ziaee V, Beygi S, Moshayedi P, Mirfazeli FS. Overuse of psychotropic medications among children and adolescents with autism spectrum disorders: a perspective from a developing country. Res Dev Disabil 2012; 33: 563-9. https://doi.org/10.1016/j.ridd.2011.10.001
Brentani, H.; de Paula, C.S.; Bordini, D.; Rolim, D.; Sato, F.; Portolese, J.; Pacifico, M.C.; McCracken, J.T. Autism spectrum disorders: An overview on diagnosis and treatment. Rev. Bras. Psiquiatr. 2013, 35, S62-S72. [CrossRef] https://doi.org/10.1590/1516-4446-2013-S104
Lai MC, Lombardo MV, Baron-Cohen S. Autism. Lancet 2014; 383: 896-910. https://doi.org/10.1016/S0140-6736(13)61539-1
Mandell DS, Morales KH, Marcus SC, Stahmer AC, Doshi J, Polsky DE. Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics 2008; 121: e441-8. https://doi.org/10.1542/peds.2007-0984
House SA, Goodman DC, Weinstein SJ, Chang CH, Wasserman JR, Mor¬den NE. Prescription use among children with autism spectrum disorders in Northern New England: intensity and small area variation. J Pediatr 2016; 169: 277-83.e2. https://doi.org/10.1016/j.jpeds.2015.10.027
Mandell DS, Morales KH, Marcus SC, Stahmer AC, Doshi J, Polsky DE. Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics 2008; 121: e441-8. https://doi.org/10.1542/peds.2007-0984
Schubart JR, Camacho F, Leslie D. Psychotropic medication trends among children and adolescents with autism spectrum disorder in the Medicaid program. Autism 2014; 18: 631-7. https://doi.org/10.1177/1362361313497537
Zito JM, Safer DJ, DosReis S, et al.: Psychotropic practice patterns for youth: a 10-year perspective. Arch Pediatr Adolesc Med. 2003, 157:17-25. https://doi.org/10.1001/archpedi.157.1.17
Pliszka S: Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/ hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007, 46:894-921. https://doi.org/10.1097/chi.0b013e318054e724
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 alrazi Eisa SHOGAR, Mohammed Elhassan Shayoup, Mohammed Sani Umar
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.