Overuse of psychotropic medications among children and adolescents with autism spectrum disorders: perspective from a developing country.
Iranian kids with autism take psychotropics twice as often as U.S. or UK peers, so always audit necessity when families cross borders.
01Research in Context
What this study did
Memari et al. (2012) asked parents of Iranian school pupils with autism about any pills their child takes. They wanted to know how many kids use psychotropic drugs and why.
The team handed out short forms. They did not test any new drug. They simply counted who was already on medication.
What they found
Four out of five pupils with autism were on at least one psychotropic drug. Antipsychotics were the most common type.
No child trait—age, sex, or symptom level—predicted who got the pills. Doctors seemed to choose by habit, not by need.
How this fits with other research
Smith et al. (2010) saw the same pattern in a U.S. registry, but only 35% of kids there used meds. The huge gap—80% vs 35%—looks like a clash, yet both surveys used parent reports. The difference is place: Iran vs U.S. rules, insurance, and culture.
Guisso et al. (2018) later tracked UK records and found 33% use. Again, the rate is far lower. All three studies agree on one point: no single child trait drives the script.
Li et al. (2025) pushed the ceiling even higher: 97% of Chinese inpatients got meds. Together these papers draw a world map where the same diagnosis meets very different pill counts.
Why it matters
If you serve a bilingual family or review meds at school, ask where they moved from. A child who arrived from Iran may already be on three drugs, while a U.S.-born peer with the same behaviors is on none. Use the intake to check each pill for clear target, dose, and side-effect log. Start a shared plan with the prescriber: keep what helps, drop what does not.
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02At a glance
03Original abstract
Psychopharmacotherapy can be an effective part of the treatment for individuals with autism spectrum disorders (ASDs). However debate continues over the potential benefits and costs of these treatments; additionally little is known about the pattern of psychotropic medication use in developing countries. We aimed to survey the use of psychotropic medication, their subcategories and its associations among a representative local sample of 345 Iranian pupils with ASDs. All required information about demographics as well as clinical and medication history of children was collected through interviews with the families. Overall, 80% of participants were currently using at least one psychotropic medication while, and up to 97% of the sample had at least one psychotropic medication claim during the last year. Antipsychotics were the most frequent medications (57.4%) while antidepressants were used by only a small proportion of participants (8.7%). Further analysis revealed no significant association between any psychotropic medication use on one hand and clinical and demographic characteristics on the other hand. Time differences, cross cultural variations, and also cost and availability of treatment options in developing countries are discussed as possible explanations for different patterns and more than expected rate of psychotropic medication use in pupils with ASD.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.10.001