Epidemiologic Features of Antipsychotic Prescribing to Children and Adolescents in Primary Care in the United Kingdom

Rani, Fariz A.; Murray, Macey L; Byrne, Patrick J.; Wong, Ian C. K.

doi:10.1542/peds.2007-2008

Cited by 171 publications

(111 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Data held include subject demographic and clinical details including data on drug prescriptions and comorbid conditions.The quality of the GPRD data has been validated in a number of studies,the completeness of medical recording is reported to be high [14],and the GPRD has been used to investigate paediatric prescribing issues [12,13].…”

Section: Methodsmentioning

confidence: 99%

“…National primary care databases provide useful sources of paediatric prescribing data in the UK [12,13]. Although NICE guidance recommends that antiobesity drugs for children and adolescents be initiated from secondary care in the UK [9], routine practice is for general practitioners (GPs) to prescribe after recommendation from paediatricians.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Rise in antiobesity drug prescribing for children and adolescents in the UK: a population‐based study

Viner

Hsia

Neubert

et al. 2009

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • The antiobesity drugs sibutramine and orlistat are not licensed for use in children and adolescents in the UK or USA.• Clinical trials suggest antiobesity drugs are effective and well‐tolerated in obese adolescents. WHAT THIS STUDY ADDS • Prescribing of unlicensed antiobesity drugs in children and adolescents has increased significantly in the past 8 years.• Most prescribed antiobesity drugs in children and adolescents are rapidly discontinued before patients can see clinical benefit, suggesting they are poorly tolerated or poorly efficacious.AIMS The international childhood obesity epidemic has driven increased use of unlicensed antiobesity drugs, whose efficacy and safety are poorly studied in children and adolescents. We investigated the use of unlicensed antiobesity drugs (orlistat, sibutramine and rimonabant) in children and adolescents (0–18 years) in the UK.METHODS Population‐based prescribing data from the UK General Practice Research Database between 1 January 1999 and 31 December 2006.RESULTS A total of 452 subjects received 1334 prescriptions during the study period. The annual prevalence of antiobesity drug prescriptions rose significantly from 0.006 per 1000 [95% confidence interval (CI) 0.0007, 0.0113] in 1999 to 0.091 per 1000 (95% CI 0.07, 0.11) in 2006, a 15‐fold increase, with similar increases seen in both genders. The majority of prescriptions were made to those ≥14 years old, although 25 prescriptions were made for children <12 years old. Orlistat accounted for 78.4% of all prescriptions; only one patient was prescribed rimonabant. However, approximately 45% of the patients ceased orlistat and 25% ceased sibutramine after only 1 month. The estimated mean treatment durations for orlistat and sibutramine were 3 and 4 months, respectively.CONCLUSIONS Prescribing of unlicensed antiobesity drugs in children and adolescents has dramatically increased in the past 8 years. The majority are rapidly discontinued before patients can see weight benefit, suggesting they are poorly tolerated or poorly efficacious when used in the general population. Further research into the effectiveness and safety of antiobesity drugs in clinical populations of children and adolescents is needed.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rise in antiobesity drug prescribing for children and adolescents in the UK: a population‐based study

Viner

Hsia

Neubert

et al. 2009

Brit J Clinical Pharma

Self Cite

View full text Add to dashboard Cite

show abstract

“…Antipsychotics are now relatively commonly used in children and adolescents for a variety of indications including mood disorders, disruptive behavior disorders, developmental disorders, and psychosis [1][2][3][4]. While weight gain when on antipsychotics has received greater attention in adults, it is also a relatively common adverse effect in children and adolescents [1].…”

Section: Introductionmentioning

confidence: 99%

Associations between the LEP -2548G/A Promoter and Baseline Weight and between LEPR Gln223Arg and Lys656Asn Variants and Change in BMI z Scores in Arab Children and Adolescents Treated with Risperidone

et al. 2018

View full text Add to dashboard Cite

Data on baseline (antipsychotics-naïve) age, weight, and height, and change in these at 3 subsequent follow-up time points up to 313.6 days (95% CI 303.5–323.7) were collected from 181 risperidone-treated children and adolescents (mean age 12.58 years, SD 4.99, range 2.17–17.7) attending a pediatric neurology clinic in Saudi Arabia. Owing to differences in genotypic distributions in the subsamples, results are reported for the white Arab population (n = 144). Age- and gender-normed body mass index (BMI)-standardized z scores (BMI z) were calculated (LMSgrowth program). Linear regression was performed for baseline weight and BMI z, while change in BMI z was assessed using random effects ordered logistic regression. The following single nucleotide polymorphisms (SNPs) were analyzed: rs7799039 in the LEP promoter, rs1805094 (previously rs8179183), rs1137100 and rs1137101 in the LEPR, and rs1414334 in HTR2C. We found a nominally significant association between rs7799309 and baseline weight, adjusting for height, age, gender, and diagnosis (A/G, p = 0.035, β = –3.62 vs. G/G). The rs1137101 (G/G, p = 0.018, odds ratio [OR] = 4.13 vs. A/A) and rs1805094 C allele carriers (p = 0.019, OR = 0.51) showed nominally significant associations with change in BMI z categories. Our data support and replicate previous relevant associations for these variants (including with weight gain when on risperidone), whilst being the first report of such associations in patients of Arab ethnicity.

show abstract

“…Antipsychotic prescriptions in children and adolescents in the UK almost doubled between 1993 and 2005 (Rani et al, 2008). This was driven by a large increase in the prescription of secondgeneration antipsychotics, whereas the prescription of first-generation antipsychotics began to fall during the latter five years of this time period.…”

Section: Introductionmentioning

confidence: 99%

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.

View full text Add to dashboard Cite

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

show abstract

Epidemiologic Features of Antipsychotic Prescribing to Children and Adolescents in Primary Care in the United Kingdom

Cited by 171 publications

References 24 publications

Rise in antiobesity drug prescribing for children and adolescents in the UK: a population‐based study

Rise in antiobesity drug prescribing for children and adolescents in the UK: a population‐based study

Associations between the <b><i>LEP</i></b> -2548G/A Promoter and Baseline Weight and between <b><i>LEPR</i></b> Gln223Arg and Lys656Asn Variants and Change in BMI <b><i>z</i></b> Scores in Arab Children and Adolescents Treated with Risperidone

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

Contact Info

Product

Resources

About