Mortality and antidepressants among individuals with autism spectrum disorder: A population-based cohort study

Aim High risk of premature mortality has been identified among individuals with autism spectrum disorder (ASD). Although possible risk factors, such as epilepsy or other comorbidities, have been described, studies investigating the association between the use of antidepressants and different causes of mortality are scarce. Methods This retrospective population-based cohort design used Taiwan’s National Health Insurance Research Database. 31,458 individuals with ASD between 2001 to 2017 were identified. Among them, 4,659 ASD patients with antidepressant use and 4,659 propensity score (PS)- matched ASD patients without antidepressant use were selected. Main outcomes of this study are all-cause mortality, and mortality due to accident, suicide, or natural causes. Result Antidepressant exposure in individuals with ASD was associated with a significantly lower all-cause mortality (aOR = 0.65, 95%CI: 0.52 ~ 0.83), as reflected in accident mortality (aOR = 0.63, 95%CI: 0.47 ~ 0.82). Among those aged 18 and above, antidepressant use was associated with a significantly decreased risk of natural cause mortality. Conclusions This study revealed that antidepressant use in patients with ASD was associated with a decreased risk of all-cause mortality, in particular, mortality from accidents or natural causes. These results may demonstrate the importance of early detection and treatments for comorbid psychiatric disorders in patients with ASD.