Trends in prescribing of psychotropic medications for inpatient adolescents in Israel: A 10 years retrospective analysis

Abstract

We examined the trends in prescribing psychotropic drugs to children and adolescents within an inpatients adolescent psychiatric ward in Israel. Data of 414 subjects, ranging from 12- to 22-year-old, covering the years 1997, 2002 and 2007, was examined retrospectively. Analyzed variables included the number and type of drug prescriptions per patient at discharge, the subjects' age at discharge and the number of diagnoses per patient at discharge. Analysis of variance (ANOVA) with repeated measures was used to evaluate changes between the three calendar years, along the 10-year study period, while Pearson χ(2) test was performed for categorical variables. Over the study period the mean age at discharge decreased significantly, by about a year and a half, the mean number of diagnoses increased significantly, from 1.6 to 2.4 diagnoses per patient and the total number of drugs prescribed at discharge increased significantly from 1.48 to 1.93 per patient. Overall, the number of patients who were prescribed mood stabilizers increased by 14%, those who were prescribed antidepressants increased by almost 24%, almost 16% in antipsychotics prescriptions and 51.5% in prescriptions of atypical antipsychotics. Typical antipsychotic prescriptions decreased by 35.5% and accordingly, the number of patients who were prescribed agents for the treatment of extra-pyramidal side effects decreased by almost 24%. Due to a low number of inpatients with attention deficit and hyperactivity disorder (ADHD), no significant statistical conclusion could be drawn regarding trends in psychostimulant prescriptions. Our findings agree with other published studies from the last two decades. The growing use of psychotropic agents in children and adolescents merit a continuous concern with regard to their effects on the developing brain and impact on quality of life and to authorizing these drugs for use in specific young age subgroups.

Variation of the prevalence of pediatric polypharmacy: A scoping review

“…Other characteristics of studies that reported a mean number of medications without reporting prevalence included evaluating multiple drugs/classes and being in international settings (Table S3). Table S3 also shows the rest of the studies that reported prevalence or average number of medications.…”

National time trend changes in psychotropic medication of child and adolescent psychiatric inpatients across Finland

“…These include the study by Gilat et al. (), which was based on data collected from an Israel adolescent psychiatry ward in 1997 and 2010 and reported a significant increase in the use of both antipsychotics and antidepressants, from 54% to 70% and from 15% to 39%, respectively. A Finnish study of four adolescent psychiatry hospital units found that the use of psychotropic medications increased from 30% in 1991 to 69% in 1999 (Haapasalo‐Pesu, Erkolahti, Saarijarvi, & Aalberg, ).…”

Antipsychotic Use in Children and Adolescents

“…D espite the increase in antipsychotic (AP) use among children and adolescents in recent years in both outpatients 1Y3 and inpatients 4,5 in the United States and Europe, there is scarce information about their prescription in the clinical practice.…”