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More Kids Get Antipsychotic Drugs
May 3, 2006 -- Children represent the fastest growing group of users of a new generation of antipsychotic medications, even though the drugs are not approved for their use and serious safety concerns remain.
Between 2001 and 2005, prescriptions for atypical antipsychotic drugs increased by 80% among children and teens, compared with an increase of 46% among adults aged 20 to 44.
In 2005, roughly 97% of all antipsychotic prescriptions written for U.S. children were atypical antipsychotics, according to an analysis conducted by pharmacy benefit manager Medco Health Solutions Inc.
While it is clear that more children are taking antipsychotic drugs, it is less clear why.
ADHD and Antipsychotic Drugs
Studies conducted at Vanderbilt Medical Center in Nashville, Tenn., suggest that the drugs are routinely prescribed for attention deficit hyperactivity disorder (ADHD).
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But a Medco official says he does not believe this is the case. Lon Castle, MD, says the increase in use is being driven by a growing recognition that children suffer from psychotic illnesses and other psychiatric conditions.
"When I was in training -- and even in practice -- the thinking was that children didn't have psychiatric conditions like schizophrenia or bipolar disorder," Castle tells WebMD. "But within the last few years, psychiatry has made dramatic strides and we are now better able to identify children who probably do have these diseases."
Increase Among Girls
Atypical antipsychotics are approved for use in adults to treat psychotic illnesses like schizophrenia and also Tourette's syndrome. But they are also widely used "off label" to treat many psychiatric conditions. "Off label" refers to prescribing drugs to treat conditions for which they are not approved by the FDA.
Atypical antipsychotics include the drugs Clozaril, Risperdal, Zyprexa, Seroquel, and Geodon.
The older antipsychotics carry a high risk of movement-related side effects.
Although the newer generation of drugs is believed to be better tolerated, few studies have been done in children. Atypical antipsychotics are known to promote weight gain, and the FDA has warned that their use is associated with an increased risk of diabetes and other obesity-related conditions.
The Medco analysis, which included 2.5 million of its 55 million members, found that prescriptions for the drugs among children and teens rose steadily between 2001 and 2005, while prescriptions for drugs approved for the treatment of ADHD remained flat.
The growth was most pronounced in girls. There was a 110% increase in prescriptions written for atypical antipsychotics among girls under the age of 20 during the years studied, compared with a 27% increase among women 20 years and older.
In 2005, about six children out of 1,000 were taking atypical antipsychotic drugs, compared with 10 adults out of 1,000, the Medco analysis found.
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