Researchers examining U.S. emergency department prescribing patterns reported a notable shift in medication use among certain patient groups after a presidential statement tying autism to the over-the-counter pain reliever Tylenol.
The analysis, published in the Lancet and led by Dr. Jeremy Faust of Harvard, compared prescribing before and after the announcement on September 22. According to the study, overall Tylenol prescriptions for pregnant patients declined by 10% in the three months following the statement. At the start of that three-month window, orders for pregnant women aged 15-44 years fell 16%, and the largest weekly drop - 20% - occurred in the third week of the period.
"This means that thousands of women did not have their pain or fever treated in ERs, likely because they were needlessly afraid," said Dr. Faust, an emergency physician at Brigham and Women’s Hospital in Boston. "We think that’s unfortunate because, among the options for pain control and fever reduction, Tylenol is the safest option," he added.
Researchers reported the decrease in Tylenol prescribing appeared to wane after several weeks, a pattern they attribute to possible counter-messaging from trusted organizations that refuted the President’s claims. The analysis found no statistically significant change in Tylenol orders for women who were not pregnant.
The study drew on electronic health record data for nearly 90,000 emergency department visits by pregnant females in the three months following the presidential warning. For comparison, the researchers analyzed about 853,000 emergency visits by non-pregnant females and 8.6 million outpatient clinical encounters among children during the same period.
Alongside the decline in acetaminophen orders for pregnant patients, the study documented a sharp increase in outpatient prescriptions for leucovorin - a form of folinic acid - for children aged 5-17 years. Overall, leucovorin prescriptions in that age group rose by 71% during the study window. At the start of the period the rate surged 93%, and the single largest weekly increase occurred in the second week, when the prescription rate more than doubled. Although prescriptions retreated from the peak, they remained markedly higher at the end of the analyzed period.
The rise in leucovorin prescribing followed the same public remarks during which the President also promoted leucovorin as a treatment for children with autism. The study quotes concerns that families could be misled by claims that the medication could transform outcomes for children with autism.
"In a time in which public trust in health, medicine, and science is under attack, it’s regrettable that so many families will have been misled into thinking that this medication could somehow miraculously change the lives of children with autism," Faust said.
Drug regulators, according to the report, said they would approve the drug based on a U.S. Food and Drug Administration review of patient data.
When asked about the findings, Andrew Nixon, a spokesperson for the U.S. Department of Health and Human Services, responded by sharing a post on X defending the government's messaging on Tylenol and characterizing it as part of its "commitment to telling the truth about public health."
The analysis highlights measurable effects on prescribing behavior in emergency and outpatient settings following high-profile public statements about medication safety and efficacy. The study authors underscore the potential clinical consequences for pregnant patients who forgo standard treatments for pain or fever and express concern about increased use of unproven therapies in children with developmental conditions.