Trends in Prescribing of Antipsychotic Medications for US Children

Cooper, William O.; Arbogast, Patrick G.; Ding, Hua; Hickson, Gerald B.; Fuchs, Douglas; Ray, Wayne A.

doi:10.1016/j.ambp.2005.11.002

Cited by 173 publications

(142 citation statements)

References 26 publications

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“…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. The increase in antipsychotic prescribing among children and adolescents is even more dramatic in the United States (US) where two to six-fold increases have been observed during similar time periods, with similar trends to those in the UK noted in the use of first-and second-generation preparations (Cooper et al, 2004;Aparasu et al, 2005;Cooper et al, 2006;Olfson et al, 2006).…”

Section: Introductionmentioning

confidence: 78%

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: Introductionmentioning

confidence: 78%

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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“…[16][17][18] Antipsychotic use increased from 8.6 per 1000 children to 39.4 per 1000 children from 1995 to 2002, for example, and antidepressant use increased from 9.4 per 1000 to 21.3 per 1000 children between 1994 and 2003. [19][20][21] The lack of clinical evidence to support the use of these agents in children has resulted in a number of controversies, including concerns over increased suicidality among adolescents treated with selective serotonin reuptake inhibitors and of antipsychotic side effects in young children. [22][23][24][25] We define the current state of pediatric research activity for neuropsychiatric disease, including the underrepresentation of certain drug classes and conditions.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Pediatric Clinical Drug Trials for Neuropsychiatric Conditions

2013

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BACKGROUND AND OBJECTIVE: Neuropsychiatric conditions represent a large and increasing disease burden in children. A number of drugs are available for the treatment of these conditions, but most drugs have not been adequately tested in children, and off-label drug use remains widespread. We sought to define and quantify recent and ongoing clinical research on the use of neuropsychiatric drugs in children. METHODS: Drug trials registered in ClinicalTrials.gov between 2006 and 2011 and studying neuropsychiatric conditions were selected and classified based on the drug’s Food and Drug Administration (FDA) approval status in children. We measured the proportion of trials seeking to expand the use of a drug to pediatric patients and the proportion of available drugs studied in children. RESULTS: Only 10% of neuropsychiatric trials focused on children. Of 303 drugs studied in both pediatric and adult populations, 90% lacked FDA approval in children and 97% were not approved in children for the indication studied. However, only 19% of all neuropsychiatric drugs were under study in pediatric populations, with as few as 8% of either antidepressant or antipsychotic drugs. Overall, 76% of pediatric drug trials examined a drug previously unapproved in children and 26% explored the use of a drug for a new indication. CONCLUSIONS: Despite the rising prevalence of neuropsychiatric disease and the paucity of FDA-approved pediatric drugs, only a small proportion of trials focus on pediatric populations and these trials cover only a fraction of available drugs. This deficiency is most pronounced for depression and schizophrenia.

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“…Childhood behavioral problems are found in all societies with an estimated worldwide prevalence ranging from 5.29% to 26% (Bloom & Cohen, 2007;Egger & Angold, 2006;Polanczyk, Silva de Lima, Horta, Biederman, & Rohde, 2007). In the United States, the prevalence of children with behavioral problems has increased markedly in the last 15 years (Buitelaar et al, 2006;Cooper et al, 2006;Egger & Angold, 2006;Zito et al, 2003;Zito et al, 2008). Prescriptions for psychotherapeutic medications directed toward reducing behavioral problems in the school aged child increased two to three fold in the early 1990"s (Zito et al, 2007) and from the mid 1990"s to 2002 rates for these medications increased from 8.6 per 1000 children to 39.4 per 1000 children (Cooper et al, 2006).…”

Section: Significance Of the Problemmentioning

confidence: 99%