Psychopharmacological treatment in children and adolescents with autism spectrum disorders in Germany.
German insurance data show psychotropic drug use in youth with ASD rose steadily to one in three, matching global trends and spotlighting the need for behavior-analytic alternatives.
01Research in Context
What this study did
The team looked at German insurance records for kids and teens with autism. They counted how many filled at least one psychotropic drug prescription in 2004 and again in 2009.
No one was given a new drug or taken off one. The study simply described what was already happening.
What they found
One in three insured youth with ASD got a psychotropic drug in 2009, up from one in four in 2004. Methylphenidate and risperidone were the most common.
The rise happened without any big change in autism diagnosis rules or new national guidelines.
How this fits with other research
Matson et al. (2011) show risperidone can calm severe behavior in kids with ID, but weight gain and drooling are common. That helps explain why German doctors keep using it.
Garwood et al. (2021) found an even higher rate—54 %—in German adults with ID. The problem grows after the teen years, so early behavior-planning is urgent.
Klein et al. (2024) tracked Canadian youth with IDD and saw the same one-in-three figure, plus heavy polypharmacy. The German snapshot now looks like part of a worldwide pattern, not a local blip.
Why it matters
High prescribing is not unique to Germany; it is the default across countries. Use the data to start conversations with prescribers. Ask for a clear behavior goal for each drug, schedule quarterly reviews, and push for a functional assessment before any new prescription. Your behavior plan can compete head-to-head with the medicine cabinet only if it is written, measured, and shared with the team.
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02At a glance
03Original abstract
Data on psychopharmacological treatment of individuals with autism spectrum disorder (ASD) are scarce, especially for European countries. This study evaluated psychopharmacotherapy utilisation in children and adolescents with a diagnosis of ASD in Germany. Data of a large statutory health insurance company were analysed and outpatients aged 0-24 years with a diagnosis of ASD during a 1-year-period (2009) were identified. For this cohort, the prescription of psychopharmacotherapy was evaluated. Aditionally, we analysed time trends in prescriptions from 2004 to 2009. One thousand one hundred twenty-four patients (75.4% male; mean age: 11.1 years) matched the inclusion criteria. The prevalence of ASD was 0.37% in males and 0.12% in females, respectively. Of all ASD patients, 33.0% were prescribed psychotropic drugs in 2009. 12.5% of ASD patients were treated with stimulants or atomoxetine, 11.7% with antipsychotics, 9.1% with antiepileptics, 6.8% with benzodiazepines, and 3.8% with antidepressants/SSRI. Regarding substances, methylphenidate (24.4% of all psychotropic prescriptions), risperidone (13.3%) and valproate (9.1%) were most frequently prescribed. Psychopharmacologic treatment prevalence was age-related and increased from 16.3% in individuals aged 0-4 years to 55.1% in 20-24 year olds. From 2004 to 2009, the proportion of ASD patients treated with psychotropic drugs rose from 25.9% to 33.0%. This naturalistic study furnishes evidence that the proportion of ASD patients treated with psychotropic drugs has grown considerably in Germany over the least years, with methylphenidate and risperidone being the most frequently prescribed substances. Compared with data from the USA, the proportion of ASD patients with psychopharmacological treatment is noticeably lower in Germany.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.05.028