Psychiatric Comorbidities and Psychotropic Medication Use in Autism: A Matched Cohort Study with ADHD and General Population Comparator Groups in the United Kingdom.
In UK primary care, only one in three people with autism use psychotropic drugs—far less than in US or clinic samples—and prescribing is driven by added psychiatric diagnoses and female sex.
01Research in Context
What this study did
Guisso et al. (2018) looked at every-day medical records in the United Kingdom. They compared people with autism to two matched groups: people with ADHD and people from the general public.
The team counted how many people in each group had ever been given a psychiatric drug. They also noted who had extra mental-health diagnoses and whether the person was male or female.
What they found
One in three people with autism had taken a psychotropic drug. That is five times more than the general public, but still lower than the ADHD group.
UK numbers were much lower than the 60–80% rates reported in United States studies. Girls and people with added psychiatric diagnoses were the most likely to receive medication.
How this fits with other research
The 33% UK rate looks small next to Memari et al. (2012) in Iran, where 80% of kids with autism were on meds. The gap comes from setting: the Iranian data came from a specialty clinic, while the UK data came from regular doctor visits.
Smith et al. (2010) and Levin et al. (2014) in the United States both found about 35–42% of children with autism using psychotropics, matching the new UK adult-plus-child figure. The similar numbers across countries show the one-in-three rate is a steady benchmark in community care.
Li et al. (2025) studied Chinese in-patients and saw 97% medicated. That extreme rate extends the UK work by showing hospital-level care pulls almost every child into drug treatment, especially when intellectual disability is present.
Why it matters
If you write assessments or sit in medication-planning meetings, know that UK practice is more cautious than headlines suggest. One-third, not one-half, of clients are likely to be medicated. Use the data to ask why a person is on a drug, to check for duplicate prescriptions, and to target behavior plans before adding new meds—especially for girls and for clients with multiple diagnoses.
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02At a glance
03Original abstract
Psychiatric comorbidities and use of psychotropic medications are common among patients with autism spectrum disorder (ASD). However, most previous research used data from the United States (US) and few studies have compared medication use in ASD to control groups, making contextualization of results difficult. In the United Kingdom (UK), general practitioners play a key role in the management of ASD. We conducted a retrospective, cross-sectional study over calendar year 2015, using primary care data from the UK. We identified a prevalent cohort of ASD cases (n = 10,856) and matched control groups of (a) general population (n = 21,712) and (b) attention deficit hyperactivity disorder (ADHD; n = 7,058) on age, sex and region. We described psychiatric comorbidities, psychotropic medications, and healthcare utilization in all three cohorts. Within the ASD cohort, we used multivariable logistic regression models to explore associations between patient characteristics and the outcomes of: any psychotropic medication, polypharmacy, and number of primary care visits. We used conditional logistic regression to compare the ASD and control groups. Psychiatric comorbidities were recorded for 41.5% of ASD patients; 32.3% received psychotropic medication and 9.8% received polypharmacy. Increased age and all psychiatric comorbidities (except conduct disorder) were associated with treatment use. Males were less likely to receive a treatment than females [Odds ratio (OR) 0.74 (0.66-0.83)]. ASD patients were more likely to take psychotropic medications than the general population [OR 4.91 (4.46-5.40)], but less likely compared to ADHD patients [OR 0.40 (0.37-0.44)]. Overall, rates of medication use in the UK were lower than those previously reported in the US. Autism Research 2018, 11: 1690-1700. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We used electronic medical records from the UK, to describe the amount of psychiatric comorbidities, psychotropic medication use and healthcare resource use in ASD. Around one in three people with ASD were prescribed a psychotropic medication, which was more than the general population, but less than for those with ADHD. Increased age, psychiatric comorbidities and female gender were all independently associated with psychotropic medication use. Rates of medication use in the UK were lower than those previously reported in the US.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.2040