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Limit High-dose Antipsychotics Medications for Children/Young Adults

Study: Limit Use of Antipsychotic Meds for Younger Patients

New research suggests restricting high-dose antipsychotic medications among children and young adults to those battling psychosis.

Investigators from the Vanderbilt University Medical Center found that children and young adults without psychosis who are prescribed high-dose antipsychotic medications are at increased risk of unexpected death.

Unexpected death includes deaths due to unintentional drug overdose or cardiovascular/metabolic causes. The study appears in JAMA Psychiatry.

In 2010, an estimated 1.3 million individuals 24 years of age or younger filled 7 million prescriptions, primarily for behavioral symptoms (such as ADHD), depression or bipolar disorders.

However, antipsychotics have potentially life-threatening effects, even in younger populations, and there are other medications for many of these conditions.

Wayne Ray, Ph.D., senior author of the study believes the findings reinforce guidelines for cautious use of antipsychotics in younger populations.

“Patients should be selected very carefully, after consideration of both drug- and non-drug-alternatives,” Ray said. “There should be a pre-treatment evaluation for factors that might amplify antipsychotic effects, such as cardiac conditions. These children and young adults should also be thoroughly monitored during treatment if they are prescribed a high-dose antipsychotic.”

Study authors searched data for about 250,000 relatively healthy children and young people (ages 5 to 24) enrolled in the Tennessee Medicaid program from January 1999 through December 2014, including new users of antipsychotic medications who received higher or lower doses and a comparison group of new users of control medications that weren’t antipsychotics.

Patients with schizophrenia or other psychoses were excluded because there are no alternatives to antipsychotics for these conditions.

The high-dose antipsychotic group of children and young adults ages 5-24 had a 3.5-fold increased risk of unexpected death, when compared with their peers in the study, while the risk for cardiovascular and metabolic deaths was increased 4.3-fold.

Source: Vanderbilt University Medical Center

Study: Limit Use of Antipsychotic Meds for Younger Patients

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Study: Limit Use of Antipsychotic Meds for Younger Patients. Psych Central. Retrieved on November 24, 2020, from
Scientifically Reviewed
Last updated: 14 Dec 2018 (Originally: 15 Dec 2018)
Last reviewed: By a member of our scientific advisory board on 14 Dec 2018
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