In one sentence
A large Australian study found that more than half of autistic children and adolescents received at least one psychotropic medication, and about one in four received more than one class, despite limited evidence for safety and effectiveness in this group.
What the researchers did
Researchers linked the Longitudinal Study of Australian Children (a nationally representative sample) with prescription records from Australia’s Pharmaceutical Benefits Scheme. They identified 390 autistic children and adolescents (233 in a younger cohort, 157 in an older cohort) and tracked psychotropic prescriptions from 2002 to 2019. They looked at how many children received medications, which classes were used, and whether patterns differed between cohorts.
What they found
- 212 of 390 (54.4%) received at least one psychotropic prescription.
- 99 (25.4%) had polypharmacy — two or more different psychotropic classes within a year.
- Antidepressants were the most common class (31.3% of the sample).
- Children in the younger cohort (born 2003–2004) were more likely to have a parent-reported diagnosis of anxiety or depression than those in the older cohort (born 1999–2000).
- There was a trend toward more psychotropic prescriptions in the younger cohort, but it did not reach statistical significance.
What this means for families and therapists
- If a psychotropic is prescribed, ask what symptom it targets and what evidence supports use in autistic children.
- Multiple medications raise the chance of side effects and interactions; review with the clinician whether each drug is still needed.
- For therapists: medications that affect mood, attention, or behavior can change how a child presents in sessions — coordinate with the prescribing clinician.
Limitations and what we don't know yet
- Autism status came from parent report and may not always match clinical records.
- Prescription data covered government-subsidized medicines; some privately paid scripts may be missing.
- The study could not tell whether drugs were for autism-related symptoms or for co-occurring conditions such as ADHD, anxiety, or depression.
- The sample may under-represent children from non-English-speaking families or remote areas.
- Effectiveness and side effects of the prescriptions were not assessed.
This is a plain-language summary of Patterns of Psychotropic Prescribing Practices in Autistic Children and Adolescents: An Australian Perspective of Two Cohorts Five Years Apart by Baldes A., May T., Brignell A. et al., Child Psychiatry and Human Development (2024). Source license: CC-BY-4.0. It is not medical advice — talk to a qualified clinician before changing therapy.