Sharp rise noted in meds for youths

Antipsychotic-drug treatment of children and teenagers seen by office-based physicians increased dramatically between 1993 and 2002, according to a national study.

In the United States, the number of office prescriptions of antipsychotic medications for young people increased from about 201,000 in 1993 to 1,224,000 in 2002, reports a team led by psychiatrist Mark Olfson of Columbia University. The results, for people 20 years old or younger, come from data collected annually from about 3,000 randomly selected physicians with office practices. The team reports the findings in the June Archives of General Psychiatry.

Psychiatrists, rather than primary care physicians, wrote the majority of antipsychotic prescriptions for the youths. Nearly all prescriptions were for the newest such medications—clozapine, risperidone, olanzapine, and quetiapine—which can produce weight gain and diabetes. The Food and Drug Administration has yet to endorse any of the new antipsychotics for use by youngsters.

White males were more likely to receive antipsychotic prescriptions than were females or males of any other race, the scientists say. Youths who received the drugs typically had diagnoses of conduct disorder or other behavior problems; mood disorders; developmental disorders or mental retardation; or psychotic disorders.

Declining psychiatric-hospital treatment for children and teens during the study period may have boosted the number of kids with mental disorders seen in physicians’ offices, contributing to the upswing in antipsychotic prescriptions, the researchers say. Data from office visits don’t include young people who received antipsychotic treatment elsewhere, such as in community clinics, the study authors add.