The number of children and teenagers being prescribed antipsychotic drugs has skyrocketed within the last few years, with psychiatrists prescribing the drugs in nearly one-in-three visits with youth, according to researchers.
“The growth in antipsychotic treatment of children — roughly eightfold in 17 years — is especially impressive,” said study author Dr. Mark Olfson, a professor of clinical psychiatry at the College of Physicians and Surgeons of Columbia University.
“Practice has overstepped research,” he said. “These rapidly rising rates of antipsychotic treatment in young people should give physicians pause.”
Mental health experts warn that these potent drugs can have serious side effects and that their effectiveness has not been proven in treating the disorders for which they’re often prescribed.
For the new study, Olfson and his team separated people into two group: children (up to 13 years old) and teens (ages 14-20).
The researchers examined data from doctor’s office visits from over several decades, and compared data from 1993 to 1998 with data from 2005 to 2009. The number of doctor’s visits in which an antipsychotic was prescribed jumped from 0.24 percent to 1.83 percent in children, and from 0.78 percent to 3.76 percent in teens.
“[That] is a pretty big leap — not huge, but substantial,” said Dr. Michael Houston, an associate clinical professor of psychiatry and pediatrics at the George Washington university medical center and a member of the American Academy of Child and Adolescent Psychiatry.
“Whether or not it is bad news is hard to determine,” added Houston, who was not involved with the study.
Doctors typically prescribed the drugs for ADHD and other behavior disorders, the researchers found, which is considered “off-label” use. The Food and Drug Administration has approved use of antipsychotics in young people primarily for treating schizophrenia, bipolar mania, Tourette’s syndrome and irritability resulting from autism. However, researchers found that these only accounted for a small portion of the prescriptions.
Risperidone was the most commonly prescribed antipsychotic medication, but the authors write that “uncertainty surrounds” the appropriateness of using that drug, as well as other antipsychotic medications, to treat ADHD and behavior disorders.
“Although antipsychotic medications can deliver rapid improvement in children with severe conduct problems and aggressive behaviors, it is not clear whether they are helpful for the larger group of children with ADHD,” Olfson said.
He also noted that there are other unanswered questions concerning antipsychotics’ long-term effect on children’s brains. Studies have shown that there are serious potential side effects, such as rapid weight gain and increased risk of diabetes.
The researchers gave several possible explanations as to why the drugs are being increasingly prescribed to young people.
One suggestion is that more and more children are being diagnosed with conditions such as bipolar disorder and autism spectrum disorders, and the FDA has approved the use of antipsychotics under those circumstances.
Or perhaps it’s simply the rise in the number of drugs—at least six new antipsychotics have been introduced to the market in the last 15 years.
“The factor that stands out the most—and is reflected in the study’s data—is that far fewer kids are receiving psychotherapy and other psychosocial interventions than we would like to see,” said Houston.
“When such medications are recommended, parents should ask a lot of questions,” he said. “’What other types of treatment, including therapy, are available? What are the possible risks, and how will my child be monitored to possibly avoid [them]? How long will my child be on this medication?’”
Source: Archives of General Psychiatry