Study finds adults with autism prescribed psychotropic drugs without diagnosis

The research collected by The Cooperative Research Centre for Living with Autism’s (Autism CRC) Australian Longitudinal Study of Adults with Autism (ALSAA) and study led by the University of New South Wales (UNSW) compared the rates of psychotropic drug prescription in 188 adults with autism and 115 people without autism.

Published on BJPsych Open, it was revealed anti-psychotics, anti-epileptics and propranolol were the most common types of medications prescribed.

Author of the study at UNSW’s School of Psychiatry Dr Rachael Cvejic says the study highlights the need for accessible and autism-specific training for clinicians.

“This is concerning, because there is little evidence to support the use of mental health medications to manage behavioural features of autism spectrum disorders and this practice exposes people to potential harms.”

“Clinicians may be having difficulties making an accurate psychiatric diagnosis in adults on the autism spectrum, or there could be potential difficulties with communication.”

Dr Cvejic says there may also be difficulty accessing appropriate non-pharmacological therapies to support behavioural issues or inadequate education about potential non-pharmacological therapies.

She also suggests patients with autism have honest conversations with their doctor about medications and see if alternative options have similar or greater benefits.

“It is very important that people on the autism spectrum weigh up the potential benefits and risks of a medication with their clinician and establish whether non-pharmacological therapies may be a potential option.”

Advisor to ALSAA researchers Julianne Higgins is also on the autism spectrum and says a better understanding among clinicians would reduce the use of medications.

“I feel that the existential autistic experience of living would be better understood if clinicians had an appreciation of autism within the context of neurodiversity,” she says.

Dr Cvejic is pushing for training programs targeted at both established doctors and medical students, saying the lacks of action in Australia is a concern.

“We currently have no way to ensure that all future health practitioners are equipped to meet the needs of people on the autism spectrum.”

Chief Executive Officer of Autism CRC, Andrew Whitehouse welcomed the move to provide clinicians with improved tools and better training to identify, diagnose and treat people on the autism spectrum who present with mental health issues.

“This very important study highlights the urgent need for more educational programs for health professionals in the area of autism and mental health. These will be critical to offering optimal healthcare and promoting the wellbeing of the significant number of Australians on the autism spectrum,” he says.

The report also suggests improved communication strategies, a greater understanding of neurodiversity, the ability to identify physical and mental health conditions and improved knowledge of non-pharmacological therapies where necessary.

The second wave of data collection is being actioned by ALSAA and Dr Cveji and her team of researchers will look at how mental health and medication use might change over time.