Antipsychotic prescribing trends: a review of pharmaco‐epidemiological studies

Verdoux, Hélène; Tournier, Marie; Bégaud, Bernard

doi:10.1111/j.1600-0447.2009.01425.x

Cited by 224 publications

(175 citation statements)

References 40 publications

(100 reference statements)

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“…Anecdotal evidence would point to the growth in the use of quetiapine and aripiprazole among children and adolescents during this time period, the latter of which is licensed for use in the over-15s. It is clear that little research into the use of psychotropics in children and adolescents has been carried out to date and we agree with previous authors who have called urgently for further research into the use of psychotropic medication in this age group (Olfson et al, 2006;Verdoux et al, 2010). It was impossible to determine the first class of medication prescribed in three patients due to the destruction of the clinical notes.…”

Section: Discussionmentioning

confidence: 44%

Psychotropic prescribing patterns among adolescents in Northern Ireland presenting with psychotic symptoms during a 5-year period

Woods¹,

Shannon²,

Davidson³

et al. 2015

Ir. j. psychol. Med.

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Objective: to report new prescriptions of psychotropic medications among adolescents presenting with new onset psychotic symptoms during a five-year period. Results: A total of 100 patients (88.5%) were prescribed some form of psychotropic medication.Over three-quarters of patients received an antipsychotic as their first medication. Risperidone (45.8%), olanzapine (24.0%) and chlorpromazine (12.5%) were the most commonly prescribed first-line antipsychotic medications. Of a total of 160 antipsychotic prescriptions, 81 (50.6%) were off-label. Prescriptions were most likely to have been deemed off-label due to medications not being licensed in under-18s (71.6% of off-label prescriptions) but other reasons were medications being used outside licensed age ranges (23.5%) and outside licensed indications (4.9%).Conclusions: This is the first study examining psychotropic prescribing patterns in a complete sample of all children and adolescents presenting with early onset psychotic episodes in a single geographical area. The observation of risperidone as the most commonly-prescribed antipsychotic was in keeping with previous studies in child and adolescent populations. Rates of off-label prescribing were lower than previously observed although our study was the first to investigate offlabel prescribing solely in children and adolescents presenting with psychotic symptoms.2

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Section: Discussionmentioning

confidence: 44%

Psychotropic prescribing patterns among adolescents in Northern Ireland presenting with psychotic symptoms during a 5-year period

Woods¹,

Shannon²,

Davidson³

et al. 2015

Ir. j. psychol. Med.

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“…The official indications for SGA medication for children younger than 13 years are few. Nevertheless, these medications are frequently used for varying indications in this age group (1,2,8,10,14). In this study, the data were collected from a geographically restricted area in Finland.…”

Section: Discussionmentioning

confidence: 99%

“…However, after a peak, SGA use seems to have declined in the USA (7,8). At the same time, the duration of SGA use in children has lengthened, indications have broadened, and offlabel use has increased (3,9,10). The use of SGAs in children and adolescents seems to be increasing from the age of 7 to 8 years onwards, predominantly in male patients (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…SGA use is also common among children with attention deficit hyperactivity disorder or disruptive behaviour disorders (2,3). SGA medication is also used for children and adolescents with various other diagnoses -such as psychosis, mood and tic disorders, and obsessive compulsive disorder -and in symptomatic treatment for aggressive behaviour despite the primary diagnosis (1,2,8,10,14).…”

Section: Introductionmentioning

confidence: 99%

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Clinical use of second-generation antipsychotics in children

Kakko

Pihlakoski

Salmelin

et al. 2017

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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Background: The use of second-generation antipsychotic (SGA) medication among child and adolescent psychiatric patients has increased worldwide in recent years. The increase appears to have been more extensive in the USA than in European countries, but the tendency is similar. However, after a peak the use seems to have declined in the USA. Simultaneously with the increasing numbers, the duration of SGA use has lengthened, indications have broadened, and off-label use has increased. Despite existing follow-up recommendations and evidence for the metabolic adverse effects of SGAs in children, research evidence has not translated into clinical practice. Objective: The aim of this study was to assess the clinical use and follow-up practices of SGA medication among child psychiatric patients of one university hospital in Finland. Method: This retrospective patient report-based study was conducted at the Child Psychiatric Clinic of Tampere University Hospital, Finland. The study sample consisted of 133 patients who were younger than 13 years when initiating SGA treatment and had an ongoing SGA medication during the study period. The study sample was divided into two groups according to diagnosis to examine whether there were differences between patients with an autistic or a developmental disorder (F83-84) and patients with other psychiatric diagnoses. Results: This study showed that SGA use in children younger than 13 years was mainly off-label. Irrespective of diagnosis, the most common indication was aggression. Especially children with psychiatric diagnoses other than developmental disorders had multiple socio-demographic risk factors and adverse life experiences in their background. The follow-up practices were diverse and partly irregular. Conclusions: A need for systematic SGA monitoring practices and dialogue between the medical specialities treating children and their families is evident.

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“…1,5,6 This strategy may be inferred from the rapid rise in atypical antipsychotic medication sales and increased use of polypharmacy. [7][8][9][10] It is estimated that nearly half of all BD patients who undergo pharmacological therapy still experience a relapse, accentuating the paucity of effective treatments for this highly diverse, complex illness. 11,12 Several studies, and APA guidelines, advise against removing medications in the remission (maintenance phase) of BD, 1,13 suggesting that doing so would significantly increase the risk of relapse, suicide, and morbidity.…”

Section: Sinopsismentioning

confidence: 99%

Medication-free Alternatives for Long-term Maintenance of Bipolar Disorder: A Case Series

Gurevich¹,

Robinson

2015

Glob Adv Health Med

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Psychopharmacological treatment has been the mainstay in long-term maintenance of bipolar disorder (BD) patients for the last 60 years. Conventionally accepted treatment options are primarily based on expert opinion rather than on well-executed, independently funded research. Investigation of maintaining patients without medications using treatment alternatives has been neglected. This clinical case series examines the outcomes of 7 BD patients who experienced a poor response or significant side effects with conventional treatment modalities. Patients were gradually and safely withdrawn from all medications. Treatment strategies were based on an individualized holistic approach using herbs, nutritional supplements, vitamins, amino acids, acupuncture, dietary recommendations, and behavioral modifications. Multiple treatment modalities were combined addressing the etiological causes for BD symptoms. Upon withdrawal from psychotropic medications, patients were free of medication-induced side effects and obtained psychiatric stability for at least 10 months. Further research is needed to investigate the long-term outcomes of BD treatment modalities based on well-defined successful outcome criteria, such as reduction in symptoms, improvement in quality of life, overall health outcomes, and cost effectiveness.

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Antipsychotic prescribing trends: a review of pharmaco‐epidemiological studies

Abstract: Considering the growing number of persons from the general population exposed to APs, population studies assessing the risk/benefit ratio of SGAP use in disorders other than psychosis are necessary, particularly in children and adolescents.

Cited by 224 publications

References 40 publications

Psychotropic prescribing patterns among adolescents in Northern Ireland presenting with psychotic symptoms during a 5-year period

Psychotropic prescribing patterns among adolescents in Northern Ireland presenting with psychotic symptoms during a 5-year period

Clinical use of second-generation antipsychotics in children

Medication-free Alternatives for Long-term Maintenance of Bipolar Disorder: A Case Series

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