June 6, 2006 – A study published today finds that doctors are using antipsychotic drugs to treat children and teens at a rapidly rising rate, often without evidence of any psychotic disorder. The majority of such prescriptions are for drugs that have not been approved for treating children and adolescents.
According to the report, published in the medical journal Archives of General Psychiatry, doctors often prescribe newer antipsychotic drugs such as clozapine and respiridone to treat depression, bipolar disorder and other more commonly diagnosed mental illnesses. The drugs are known as "second generation" antiphyschotic drugs. The Federal Drug Administration has not approved any second-generation antipsychotics for pediatric use, the study noted. Such off-label prescriptions are legal in the United States.
Noting that little is known about how the drugs affect youths, the researchers called for more study and scrutiny.
"In recent years, second-generation antipsychotic medications have become common in the office-based mental health treatment of young people," the study authors wrote. "In light of the widespread and growing use of these medications, there is a pressing need to increase and extend the experimental evaluation of these medications in children and adolescents."
More than nine in ten psychiatric prescriptions given to young people between 2000 and 2002 were for atypical antipsychotics, the study found. Citing an earlier study, the researchers noted that "77 percent of youth who received an antipsychotic medication did not have a diagnosis of a psychotic disorder." The seemingly high percentage reflects the popularity of off-label prescriptions, the study said.
The number of prescriptions for all antipsychotic medications given to people under 20 jumped from an average of 201,000 per year in 1993 to 1,224,000 in 2002.
The research analyzed dozens of studies and federal data. It was funded in part by grants from the National Institutes of Health and the Foundation Fellowship in Child and Adolescent Psychiatry.
Part of the dramatic increase can be attributed to a rise in office visits, from almost 275 per 100,000 in 1993 to 1,438 per 100,000 in 2002, the study found. In addition, the researchers concluded, a drop in inpatient space for young people with mental illness and the fewer documented side affects from the newly available antipsychotic drugs figured prominently into physicianâ€™s caregiving decisions.