Psychotropic medication trends among children and adolescents with autism spectrum disorder in the Medicaid program.

Ellingsen et al. (2014) looked at Medicaid records for kids with autism. They counted how many got psychotropic meds and which kinds.

The team tracked trends from 2000 to 2003. They wanted to see if pill counts were rising or falling.

Two out of every three kids with autism were on at least one psychotropic drug. Antipsychotics were the fastest-growing class.

More kids were taking two or more meds at the same time. This mix-and-match pattern is called polypharmacy.

Yamashiro et al. (2019) and Mahé et al. (2025) show the same high drug use continues into adulthood. The numbers stay high, so youth trends are not a short phase.

Koegel et al. (2014) used the same Medicaid kids and found only half of families stick with the prescribed meds. High prevalence does not equal high adherence.

Soto et al. (2024) gives hope: an emotional-development assessment helped adults with ASD cut antipsychotic doses. The target paper warns of rising use; F et al. show we can reverse it.

If you serve Medicaid-enrolled youth with ASD, expect most to arrive on psychotropics. Pair each medication with a behavior plan and schedule regular reviews. Track side effects and ask if each pill still has a clear purpose. When you see polypharmacy, flag the case for team rounds and consider an emotional-development assessment as a taper roadmap.