Antipsychotic Drug Prescriptions for Kids Soaring

As seen on EurekAlert, on Healthday, the New York Times, and elsewhere

The use of antipsychotic drugs prescribed for children has soared six-fold since the early 1990s, a new report finds.

The surge appears to be largely due to doctors who prescribe the drugs to treat mental illnesses -- including behavior disorders and mood disorders -- that don't have a psychotic component. In many cases, the U.S. government frowns on such "off-label" treatment, but it is legal.

The report findings are a cause for concern, because it's not clear how the drugs work in children, said study lead author Dr. Mark Olfson, professor of clinical psychiatry at Columbia University College of Physicians & Surgeons.

EurekAlert has mostly the hard numbers:

A steadily increasing number of patients younger than age 20 received prescriptions for antipsychotic medications between 1993 and

2002, according to a report published in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

The number of outpatient health care visits during which patients between the ages of 0 and 20 years received antipsychotic medications increased six-fold between 1993 and 2002, from a yearly average of 201,000 between 1993 and 1995 to 1,224,000 in 2002. For every 100,000 individuals younger than age 21 in the United States, 274.7 such office visits took place each year from 1993 to 1995, compared with 1,341 each year from 2000 to 2002. Overall, 9.2 percent of mental health visits and 18.3 percent of visits to psychiatrists included antipsychotic treatment. Diagnoses among the patients receiving these medications included disruptive behavior disorder (37.8 percent), mood disorders (31.8 percent), pervasive developmental disorders or mental retardation (17.3 percent) and psychotic disorders (14.2 percent). Male and white youth were most likely to receive such treatments.

Of course, the psychs say this is a good thing:

"In recent years, second-generation antipsychotic medications have become common in the office-based mental health treatment of young people," they conclude. "These medications are used to treat children and adolescents with different mental disorders. Results of clinical trials provide a limited base of support for the short-term safety and efficacy of some second-generation antipsychotic medications for psychosis and disruptive behavior disorders. 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."

The typical news response seems to rather clueless. Nearly one in five psychiatric visits for young people included a prescription for antipsychotics.