Study examines antipsychotic medication for children with autism

A new study has suggested that children with intellectual difficulty or autism are more likely to be given antipsychotic medication from a younger age than those without intellectual disability and have higher rates of hospitalisation for depression and for injury and also are at risk of other medical side effects.

Antipsychotic medication can be prescribed for young people with serious mental conditions such as schizophrenia. Some antipsychotic medications have also been used to reduce aggression in children with disruptive behaviour. They are also sometimes used for short term management short-termeople with explosive anger.

The study, led by Professor Sinead Brophy of the University’s Medical School examined how antipsychotics are used in the NHS, by linking hospital, general practitioner and educational records for 3028 young people who had been prescribed an antipsychotic.

It was found that children with intellectual difficulty or autism were more likely to be given an antipsychotic. The study found:

• 2.8% had been prescribed antipsychotics
• 75% of these children had autism
• This compares with 0.15% of those without intellectual disability.

Those with intellectual disability or autism were prescribed them younger and for a longer period than those without intellectual disability or autism. The research found that 50% of those with intellectual disability or autism had more than 12 prescriptions compared to 25% of those without intellectual disability or autism.

For young people who did not have intellectual disability or autism, there were lower rates of depression and injury after the antipsychotic, but for those with autism or intellectual disability there were higher rates of being hospitalised for depression and for injury. This is possibly because it has a sedative effect and makes children more injury prone and if the child did not have a manic or agitated type mental health condition beforehand, it can lead to depression.

Antipsychotics are known to be associated with increasing seizures in those with epilepsy. In some people certain antipsychotics can cause weight gain and potential diabetes and reducing swallowing and so leaving people open to respiratory infections.

The study found evidence of higher rates of epilepsy, diabetes and respiratory infection requiring hospital admission in all young people, with and without autism or intellectual disability, who are on antipsychotics, compared to rates before being prescribed antipsychotics and compared to those not on antipsychotics.

Professor Brophy said: “Our research suggests that young people with intellectual difficulty or autism are more like to be prescribed antipsychotic medication than those with a psychotic diagnosis, and are prescribed this medication at a younger age and for a longer period of time.

“Treating behavioural problems in this way can lead to increased costs to the NHS in terms of higher epilepsy, respiratory infection, diabetes, depression and injury all requiring more visits to the GP and hospital. In addition, treating behavioural problems in this way can have long term health implications for the individual and for those who care for them.”

The study has been published in the Journal of Child and Adolescent Psychopharmacology.