Raising the Question: Medication Mix-Up or Diversion

Area of Science:

• Pediatric Neurology
• Autism Spectrum Disorder Research
• Sleep Medicine

Background:

• Autism spectrum disorder (ASD) often presents with sleep disturbances.
• Sleep maintenance insomnia can significantly impact a child's daily functioning and family well-being.
• Standard behavioral and environmental interventions may not resolve persistent sleep issues in children with ASD.

Observation:

• A case study involving an 8-year-old boy with ASD and chronic sleep maintenance problems.
• Initial treatment with gabapentin liquid led to sustained nighttime sleep, a first for the patient.
• Subsequent early refill requests and rapid depletion of medication raised concerns about potential prescription diversion.

Findings:

• Gabapentin demonstrated significant efficacy in achieving sleep maintenance in a pediatric patient with ASD.
• The case highlights the potential for gabapentin in managing refractory sleep issues in this population.
• Unusual medication depletion patterns necessitate careful clinical evaluation for diversion.

Implications:

• Gabapentin may be a valuable therapeutic option for sleep maintenance insomnia in children with ASD.
• Clinicians must remain vigilant for signs of prescription drug diversion, especially with liquid formulations.
• Further research is warranted to explore gabapentin's role and safety in pediatric sleep disorders associated with ASD.