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We aimed to describe and compare trends in antidepressant prescribing, indications, doses and durations in autistic and non\u2010autistic males and females in the United Kingdom (UK) from 1997 to 2023. Using population\u2010representative UK primary care records, we defined three autistic groups\u2014autistic adults with intellectual disability (ID), autistic adults without ID and all autistic adults\u2014and four non\u2010autistic groups. In each calendar year we calculated: annual, lifetime and new antidepressant prescribing; indications for serotonin\u2010selective reuptake inhibitor initiation; average doses prescribed for citalopram, fluoxetine, and sertraline; and the proportion of courses that lasted over 1, 2, and 3\u2009years. We also repeated analyses with sex\u2010stratification. In all, 34,173,295 non\u2010autistic adults and 172,242 autistic adults were included (47,011 with ID and 125,231 without ID). 30% of autistic adults and 14.7% of non\u2010autistic adults were prescribed an antidepressant in 2023. Prescriptions, doses and course durations increased over time for all groups. Prescriptions were highest in autistic adults without ID and females, whereas course durations were highest in autistic adults with ID. Recording of depression and anxiety as indications was lower for those with ID. Antidepressant prescribing has increased more for autistic adults than non\u2010autistic adults since 1997, with more new starters, higher doses and longer course durations. This potentially increases the risk of adverse medication effects for autistic adults and emphasizes the need for stronger evidence around the effectiveness and tolerability of mental health interventions and the reasons for systematic differences in prescribing.<\/jats:p>","DOI":"10.1002\/aur.70360","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:28:31Z","timestamp":1787837311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antidepressant Prescribing Trends for Adults With and Without Autism in the United Kingdom From 1997 to 2023: A Population\u2010Based Cohort Study Using Clinical Practice Research Datalink Aurum"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8956-5918","authenticated-orcid":false,"given":"Aws","family":"Sadik","sequence":"first","affiliation":[{"name":"MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"Avon and Wiltshire Mental Health Partnership NHS Trust  Bristol UK"},{"name":"NIHR Bristol Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Golam M.","family":"Khandaker","sequence":"additional","affiliation":[{"name":"MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"Avon and Wiltshire Mental Health Partnership NHS Trust  Bristol UK"},{"name":"NIHR Bristol Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"},{"name":"NIHR Bristol Clinical Research Facility University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6845-7590","authenticated-orcid":false,"given":"Antonio F.","family":"Pardi\u00f1as","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2409-023X","authenticated-orcid":false,"given":"Michael","family":"Lundberg","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3635-8034","authenticated-orcid":false,"given":"Brian K.","family":"Lee","sequence":"additional","affiliation":[{"name":"A.J. Drexel Autism Institute Drexel University  Philadelphia Pennsylvania USA"},{"name":"Department of Epidemiology and Biostatistics Drexel University Dornsife School of Public Health  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Magnusson","sequence":"additional","affiliation":[{"name":"Department of Global Public Health Karolinska Institutet  Stockholm Sweden"},{"name":"Centre for Epidemiology and Community Medicine Region Stockholm  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7239-3523","authenticated-orcid":false,"given":"Dheeraj","family":"Rai","sequence":"additional","affiliation":[{"name":"MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"Avon and Wiltshire Mental Health Partnership NHS Trust  Bristol UK"},{"name":"NIHR Bristol Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"},{"name":"NIHR Applied Health Collaboration South West  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-9486","authenticated-orcid":false,"given":"Paul","family":"Madley\u2010Dowd","sequence":"additional","affiliation":[{"name":"MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"NIHR Bristol Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2307\/2685469"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-019-04291-8"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-020-04841-5"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-021-02131-8"},{"key":"e_1_2_12_6_1","volume-title":"What Are the Most Commonly Prescribed Medicines? 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