Antidepressant Use Rises More Sharply Among Autistic Adults in the UK from 1997 to 2023
Increasing Antidepressant Prescriptions Among Autistic Adults
Recent research examining UK primary care data from 1997 to 2023 reveals a notable rise in antidepressant prescribing among autistic adults compared to their non-autistic counterparts. The study analyzed records of over 172,000 autistic adults and more than 34 million non-autistic adults, highlighting differences in prescription rates, dosages, and treatment durations.
The original study was published online ahead of print in Autism Research.
Key Findings on Prescribing Trends
By 2023, approximately 30% of autistic adults had been prescribed antidepressants, more than double the 14.7% observed in non-autistic adults. The increase in prescriptions was particularly pronounced among autistic individuals without intellectual disability (ID) and among females. Additionally, the study found that the doses prescribed for common antidepressants such as citalopram, fluoxetine, and sertraline have increased over time across all groups.
Longer treatment durations were also noted, with autistic adults with ID tending to have the longest courses of antidepressant therapy. The proportion of treatment courses lasting over one, two, and three years rose steadily during the study period.
Context and Possible Implications
While antidepressant use has grown generally, the sharper rise among autistic adults may reflect increased recognition of mental health needs in this population or differences in clinical management. Interestingly, the recording of depression and anxiety as reasons for starting selective serotonin reuptake inhibitors (SSRIs) was less frequent among autistic adults with ID, suggesting that prescribing may sometimes be for other indications or that diagnostic recording practices vary.
Longer and higher-dose antidepressant use raises concerns about potential adverse effects, especially given the limited evidence on the effectiveness and tolerability of these medications specifically for autistic adults. This underscores the importance of further research to clarify the benefits and risks of antidepressants in this group and to understand the factors driving these prescribing patterns.
Considerations for Families and Healthcare Providers
Families and clinicians should be aware that antidepressant prescribing trends differ between autistic and non-autistic adults, with autistic individuals more likely to receive these medications at higher doses and for longer periods. Decisions about treatment should be individualized, carefully weighing potential benefits against possible side effects, and considering alternative or complementary mental health interventions.
Limitations and Cautions
The study is observational and based on primary care records, which may not capture all clinical details or reasons for prescribing. The findings show associations rather than causation, and further investigation is needed to understand the underlying causes of these trends and their clinical outcomes.
In summary, antidepressant prescribing has increased substantially among autistic adults in the UK over the past 25 years, with notable differences by intellectual disability status and sex. This highlights a need for enhanced evidence to guide safe and effective mental health care in this population.
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