White House autism stance tied to acetaminophen, leucovorin prescribing shifts

Clinical takeaway: Anticipate questions about avoiding acetaminophen in pregnancy and about leucovorin for autism; current evidence supports acetaminophen as the safer option in pregnancy and does not support leucovorin beyond cerebral folate deficiency.

On September 22, 2025, a White House briefing endorsed leucovorin for autism and warned against acetaminophen in pregnancy, citing autism concerns. Whether high-profile messaging like this moves patient behavior and clinical practice had been unclear. Two new analyses tracked what happened next: one in online searches, one in actual prescribing.

In the EHR analysis, new outpatient leucovorin prescriptions for children aged 5 to 17 rose 71% over the study period versus volumes expected from pre-briefing trends, peaking at more than double the expected rate in the second week. Acetaminophen orders for pregnant emergency department patients aged 15 to 44 fell about 10% over the same period, with a steeper 16% drop in the first month. Non-pregnant women the same age showed no significant change nor did comparator drugs (opioids and Lactated Ringer's solution).

The search analysis captured the upstream signal. In the two weeks after the briefing, Google searches for leucovorin ran 379% above expected and acetaminophen searches paired with autism or pregnancy more than 13-fold above expected, while control products, multivitamin and diphenhydramine, stayed flat.

Purchasing-interest searches for leucovorin, folinic acid, or folate combined rose about 203%, suggesting intent to act rather than curiosity alone. Two autism medications, aripiprazole and risperidone, showed smaller prescribing increases late in the window, which the authors attribute to possible spillover or substitution during a November leucovorin shortage.

The prescribing data came from a Lancet correspondence using Epic Cosmos, an EHR dataset covering more than 294 million US patients, analyzed with an interrupted time series comparing observed orders and prescriptions to modeled pre-briefing projections through early December 2025. The search data came from a JAMA Network Open cross-sectional study using Google Trends, comparing observed query rates in the two weeks after the briefing with rates forecast from the prior eight weeks.

The prescribing model didn't adjust for the usual late-autumn rise in acetaminophen use, which may account for part of the rebound. And because the leucovorin analysis wasn't restricted to children with autism, the 71% increase likely understates the change in that group.

Together, the two analyses trace a single arc: a high-profile announcement moved what patients searched for and what clinicians ordered within weeks. The effect echoes drug-interest spikes seen after political messaging during the COVID-19 pandemic.

"Here, no new data were presented, and yet immediate use changes were observed," summed up the authors of the Lancet analysis on the impact of the briefing.

Source: Patel NG. JAMA Netw Open. 2026 Jun 11. Internet searches for leucovorin, folate, and acetaminophen after a White House autism announcement; Faust JS. Lancet. 2026 Mar 14. Changes in paracetamol and leucovorin use after a White House briefing