Jun 06, 2006
Doctors in 2002 prescribed antipsychotic drugs to children and adolescents at five times the rate they did in 1993, according to a study published on Monday in the Archives of General Psychiatry, the New York Times reports. The study, the most comprehensive to date on the use of antipsychotic drugs in children and adolescents, examined data from the National Center for Health Statistics' survey on doctors' office visits. Researchers from Columbia University calculated the number of visits in which an antipsychotic drug was prescribed to individuals under age 21 and analyzed the patients' medical histories. They found that the number of visits that resulted in prescriptions for antipsychotic drugs increased from 201,000 between 1993 and 1995 to 1,224,000 in 2002. The study also finds that:
* In 2002, antipsychotic drugs were prescribed to 1,438 children per 100,000, up from 275 children per 100,000 between 1993 and 1995;
* About one-third of children who received antipsychotic drugs had behavior disorders, one-third had psychotic symptoms or developmental problems and one-third had mood disorders;
* Overall, more than 40% of children who received an antipsychotic drug were taking at least one other antipsychotic medication;
* Between 2000 and 2002, more than 90% of prescriptions analyzed were for newer atypical antipsychotic drugs -- including Janssen Pharmaceutica's Risperdal and Eli Lilly's Zyprexa -- which were introduced in the early and mid-1990s;
* Caucasian boys are the most common recipients of antipsychotic medications; and
* Psychiatrists were more likely than other doctors to prescribe antipsychotic drugs to children.
Experts attribute the increased use of antipsychotic drugs to a growing comfort level "with a new generation of drugs for psychosis" and "to the growing number of children and adolescents whose problems are given psychiatric labels once reserved for adults," the Times reports. They said decreased access to long-term psychotherapy and hospital care, as well as the availability of the newer drugs -- which have fewer side effects -- also could play a role. Lead author Mark Olfson, a professor of clinical psychiatry at Columbia, said antipsychotic drugs are used frequently in part because psychiatrists have "few other pharmacological options in certain patients."
Doctors expressed concern about the increasing use of antipsychotic drugs in children and adolescents, in part because "little [is] known" about their impact, the Times reports. "We are using these medications and don't know how they work, if they work or at what cost," John March, a professor of child and adolescent psychiatry at Duke University, said. He added, "It amounts to a huge experiment with the lives of American kids, and what it tells us is that we've got to do something other than [what] we're doing now." Melissa DelBello, an associate professor of psychiatry at the University of Cincinnati, said the field "desperately needs more research" to understand how antipsychotic drugs affect children but added that many young patients with bipolar disorder experience more symptom relief from the drugs than they do with other treatments (Carey, New York Times, 6/6).