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Antipsychotic Prescribing for Children, Adolescents Doubled Over 20 Years
Over 2 decades, the proportion of antipsychotics prescribed to children and adolescents in England doubled, according to study findings published online ahead of print in The Lancet Psychiatry.
“This finding was partly explained by an increase in the rate of new prescriptions, and partly by a trend towards more repeat prescriptions,” wrote corresponding author Matthias Pierce, PhD, and coauthors from the University of Manchester in England. “Although prescribing trends were similar between different areas of deprivation, typical antipsychotic prescribing was more frequent for children in more deprived areas.”
The cohort study included 7.2 million children and adolescents, ages 3 through 18, from a large English primary care database. Over a median 4.1 years of follow-up, 0.3% of the cohort, or 19,496 of the children and adolescents, received antipsychotic prescriptions. Of the 243,529 antipsychotics prescribed, 92.7% were for atypical antipsychotics and 7.3% were for typical antipsychotics.
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Between 2000 and 2019, the annual period prevalence of antipsychotic prescriptions for children and adolescents rose from 0.057% to 0.105%. Analyses showed the period prevalence of all antipsychotic prescriptions rose an average 3.3% per year, while new prescriptions increased 2.2% per year. The most likely indications for new prescriptions were for autism spectrum disorder (12.7%), nonaffective psychosis (8.6%), anxiety disorders (7.5%), attention-deficit/hyperactivity disorder (7.1%), depression (6.4%), and conduct disorders (6.1%).
“The evidence to date suggests an increasing tendency towards managing the mental health of young people by prescribing antipsychotics for a longer period of time, for a wider range of reasons, and to a broader group of children and adolescents. This tendency is of concern…” researchers wrote. “We recommend reviews be conducted into the short-term and long-term safety of atypical and typical antipsychotics in children and adolescents, and that new recommendations should be issued urgently.”
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