The Use of Psychotropic Medication in Iranian Children with Developmental Disabilities.

Roy Mcconkey,Laurence Taggart,Sayyed Ali Samadi,Ameneh Mahmoodizadeh

doi:10.3390/ijerph18084120

Abstract

The use of psychotropic medication in children is increasing worldwide. Children with developmental disabilities seem to be prescribed these medications at a higher rate compared to their non-disabled peers. Little is known about prescribing in non-Western, middle-income studies. In Iran, the file records of 1133 children, aged 2 to 17 years, assessed as having autism spectrum disorder (ASD) or an intellectual disability (ID) in Tehran City and Province from 2005 to 2019 were collated, and information from parental reports of medications was extracted. Upwards of 80% of children with ASD and 56% of those with ID were prescribed a psychotropic medication with around one quarter in each group taking two or more medications. The rates were higher among male children showing difficult-to-manage behaviors such as hyperactivity, but less so for children of fathers with higher levels of education. The lack of alternative management strategies may be a significant driver for the use of psychotropic medications in Iran and other Low and Middle Income countries, despite their known side effects, and their failure to address the developmental needs of the children. Rather, multi-disciplinary, behavioral, therapeutic, and educational interventions are required, but these are not available widely in Iran, although a start has been made.

Highlights

The present study aimed to examine more recent data on psychotropic medications with a younger and larger cohort of Iranian children with autism spectrum disorder (ASD) and those with intellectual disabilities as they rarely feature in the international literature
The pattern of medication usage was similar for the children at all levels of ASD
High proportions of Iranian children with ASD and intellectual disability (ID) receive psychotropic medication, including children aged five and under. This is despite the known side effects of using these medications, some of which are not licensed for use in children

Summary

Introduction

International concern has been expressed about the overuse of psychotropic medication in children and those with conditions such as autism spectrum disorder (ASD) and intellectual disabilities (ID) [1]. A meta-analysis of 13 studies [2] of ASD youth aged 8–11 years (totaling 96,688 participants) reported that 17.5% (95% confidence interval, 13.7% to 22.1%) received antipsychotics with a suggestion that this proportion had increased in recent years. 8000 youth with ASD individually matched to 10 peers without ASD 80,000) found that those with ASD were over 11 times more likely to be prescribed psychotropic medication. Their use was fairly rare among pre-school children with ASD (5.7%)

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Discussion

Conclusion