Factors Influencing the Use of Second-Generation Antipsychotics in Patients With Autism Spectrum Disorders

OBJECTIVES: Autism spectrum disorder (ASD) encompasses a group of neurodevelopmental disorders characterized by a multifaceted origin, impacting approximately 1 in 36 children and 2.2% of adults. This study aims to assess the factors influencing the utilization of second-generation antipsychotics in patients diagnosed with ASD.

METHODS: The study employed AHRQ claims data from the year 2016, focusing on patients across all age groups diagnosed with ASD. The initial prescription fill date is considered the index date, and baseline characteristics were established during the three months preceding this index date. To discern variations in sociodemographic characteristics among ASD patients, Chi-square tests were employed. Additionally, logistic regression was used to explore the odds ratios for factors associated with the utilization of SGA in individuals with ASD.

RESULTS: In our study, a total of 5580 patients diagnosed with ASD were included, with 805 individuals (14%) receiving SGA, while 4775 (86%) did not receive SGA. A greater percentage of individuals belonged to the 0-17 age group, specifically 81.8% in the non-SGA group and 65.59% in the SGA group. The logistic regression analysis revealed several significant associations. Females demonstrated a lower likelihood of using SGA compared to males (OR=0.76, 95% CI: 0.66-0.94). Similarly, patients with coexisting epilepsy had lower odds of receiving SGA compared to those without epilepsy (OR=0.25, 95% CI: 0.16-0.40). Regarding medication use, patients taking SSRI had substantially higher odds of being prescribed SGA (OR=7.70, 95% CI: 6.34-9.49). Additionally, patients using stimulants (OR=2.48, 95% CI: 1.93-3.18), anxiolytics (OR=2.91, 95% CI: 1.43-5.89), and mood stabilizers (OR=12.86, 95% CI: 9.81-16.85) also exhibited increased odds of being prescribed.

CONCLUSIONS: ASD patients who are on comedications have a higher risk of using SGA than those who do not. Hence, comprehensive assessment and treatment options should be considered while treating ASD patients as many diagnoses are interrelated.