Prescriptions of antipsychotic medications in young children is declining

November 09, 2020

The use of antipsychotics in young children is declining but doctors continue to prescribe these medications off-label for conditions not approved by the Food and Drug Administration and without the recommended psychiatric consultation, a Rutgers study found.

The study, published in the Journal of the American Academy of Child and Adolescent Psychiatry, looked at 301,311 antipsychotic prescriptions filled by privately insured children ages 2 to 7 in the United States from 2007 to 2017.

While results are encouraging that antipsychotic prescribing declined in recent years, the researchers noted that they continued to be prescribed for conditions lacking safety and effectiveness data such as conduct disorder, ADHD, anxiety and depression.

"We lack information on the effectiveness and safety of antipsychotics for treating those conditions in young children," said lead author Greta Bushnell, a member of the Rutgers Institute for Health, Health Care Policy and Aging Research and an assistant professor at Rutgers School of Public Health. "Guidelines recommend that psychosocial services are used before antipsychotic treatment and that children are carefully assessed before initiating antipsychotics. However, fewer than half of the children receiving antipsychotic treatment in our study had a visit with a psychiatrist or a psychotherapy claim."

Pervasive developmental disorders (PDD) -- characterized by delays in the development of socialization and communication skills -- accounted for the most antipsychotic prescribing in recent years.

"While there is some evidence supporting the use of antipsychotics in young children with PDD or intellectual disabilities, antipsychotics are not FDA approved for conduct disorders or ADHD," said Bushnell. "Despite continued prescribing, there is limited evidence for the efficacy of antipsychotics for conduct or disruptive behavior disorders in very young children and the long-term outcomes remain poorly understood."

In addition, the study found that antipsychotics were more often prescribed to boys, especially between ages 6 and 7, and that most of the children receiving antipsychotics also filled a prescription for another class of psychotropic medications, such as stimulants, clonidine or guanfacine for managing ADHD symptoms, and antidepressants.

Children who take antipsychotic medication are at risk of weight gain, sedation, diabetes, high cholesterol, cardiovascular disease and unexpected death. In very young children, antipsychotics might cause developmental and other long-term adverse effects. "The low rate of use of safer first-line psychosocial treatments, such as parent-child interaction therapy or cognitive-behavioral therapy, potentially puts children at unnecessary risks associated with antipsychotic treatment," Bushnell said.
-end-
The study was co-authored by Stephen Crystal at the Rutgers Institute for Health, Health Care Policy and Aging Research.

Rutgers University

Related ADHD Articles from Brightsurf:

Autism and ADHD share genes
Researchers from the national psychiatric project iPSYCH have found that autism and ADHD share changes in the same genes.

ADHD across racial/ethnic groups
This study of patients from diverse racial/ethnic backgrounds who received care at the Kaiser Permanente Northern California health system looked at how common attention-deficit/hyperactivity disorder (ADHD) diagnoses were over a 10-year period across seven racial/ethnic groups.

Cycles of reward: New insight into ADHD treatment
Researchers at the Okinawa Institute of Science and Technology Graduate University (OIST) in collaboration with scientists at the University of Otago and the University of Auckland in New Zealand, investigated the actions of the drug in rats.

Young mums more likely to have kids with ADHD
Young mothers have a greater chance of having a child with attention deficit hyperactivity disorder (ADHD) according to new research from the University of South Australia.

ADHD medication: How much is too much for a hyperactive child?
When children with ADHD don't respond well to Methylphenidate (MPH, also known as Ritalin) doctors often increase the dose.

Antipsychotic use in youths with ADHD is low, but still cause for concern
A new study eased fears about the proportion of youths with ADHD taking antipsychotic drugs, but still found that many prescriptions may be inappropriate.

How stimulant treatment prevents serious outcomes of ADHD
Analysis quantifies the extent which stimulant treatment reduces serious outcomes in children and young adults with ADHD.

Did Leonardo da Vinci have ADHD?
Leonardo da Vinci produced some of the world's most iconic art, but historical accounts show that he struggled to complete his works.

More sleep may help teens with ADHD focus and organize
Teenagers with attention deficit hyperactivity disorder (ADHD) may benefit from more sleep to help them focus, plan and control their emotions.

Researchers have found the first risk genes for ADHD
A major international collaboration headed by researchers from the Danish iPSYCH project, the Broad Institute of Harvard and MIT, Massachusetts General Hospital, SUNY Upstate Medical University, and the Psychiatric Genomics Consortium has for the first time identified genetic variants which increase the risk of ADHD.

Read More: ADHD News and ADHD Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.