Active Psychotropic Medication Use and Clinical Correlates in Children and Adolescents with Autism Spectrum Disorder

Abstract

Objective: The aim of this study was to describe active psychotropic medication records and agent-level patterns in children and adolescents with autism spectrum disorder (ASD), estimate psychotropic polypharmacy, and identify characteristics associated with an active psychotropic medication record. Method: This single-centre retrospective cross-sectional study included patients with ASD aged 36–216 months who attended a tertiary child and adolescent psychiatry clinic during 2025. Of 172 records assessed, five patients with cognitive impairment attributable to an identified cause other than ASD were excluded; 167 were analysed. Current medications not documented as discontinued were classified as active. Polypharmacy was defined as at least two active psychotropic medications at the same visit. Results: At least one active psychotropic medication was recorded for 123 patients (73.7%; 95% CI 66.5%–79.7%), and polypharmacy for 94 (56.3%; 95% CI 48.7%–63.6%); among the 123 patients with an active record, the polypharmacy proportion was 76.4%. At least one antipsychotic was recorded for 112 patients (67.1%) and at least two for 30 (18.0%). ADHD (aPR = 2.51; 95% CI 1.77–3.55) and irritability (aPR = 1.55; 95% CI 1.28–1.89) were independently associated with an active medication record. Conclusion: Active psychotropic medication records and record-based polypharmacy were frequent in this tertiary-care sample, reflecting electronic health record documentation rather than confirmed medication intake.