Over-Prescribing Antipsychotics to Kids
Written by Faith Anderson on August 9, 2012
Antipsychotics Prescribed as Off-Label Treatments for Kids
As the lead author of this new study, Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University in New York, states, “[Antipsychotics are] approved for schizophrenia and bipolar disorder and irritability with autism.” Olfson’s study, which was published Monday in the Archives of General Psychiatry, sought to explore the trend of over-prescribing antipsychotics to children, and found that about 90% of antipsychotic prescriptions written during office visits for kids and teens between 2005 and 2009 were “off label,” which means they were prescribed for a use other than what the FDA has approved them for. Although Olfson’s study can’t determine whether the antipsychotic prescriptions were unnecessary, the effectiveness of antipsychotic drugs in treating disorders like ADHD is uncertain, and they have been linked to side effects like diabetes and weight gain.
Diabetes and Weight Gain Side Effects of Antipsychotics
According to a large study of children conducted last year, kids who took antipsychotic medications like Abilify and Seroquel had a four-fold increased risk of developing diabetes, compared to their peers who were not taking the drugs. In September 2011, an FDA advisory board also voiced significant concerns about the use of antipsychotic drugs in children, and advised the federal agency to monitor weight gain and other metabolic diseases in kids prescribed antipsychotics. Although antipsychotic drugs haven’t been approved by the FDA for use in children with ADHD, physicians in the United States are permitted to prescribe medications for off-label uses if they deem the treatment safe and effective. The question is: Are antipsychotic drugs truly safe and effective for young children and teens? “For some of these kids, taking these [drugs] can be setting themselves up for metabolic problems in the future,” Olfson warns.
Antipsychotic Prescriptions for Children on the Rise
In the study, Olfson and his colleagues reviewed information on nearly half a million doctors’ visits in the U.S. between 1993 and 2009. According to the report, antipsychotic prescriptions increased across all age groups overall (including adults), although the increase was more rapid among young children and teens. More specifically, the number of children prescribed antipsychotics increased from 0.24 for every 100 patients between 1993 and 1998, to 1.83 per 100 between 2005 and 2009. For teens, the number increased from 0.78 for every 100 patients in the 90s, to 3.76 per 100 in the 2000s. “There is very little question as to whether these drugs are being prescribed in kids much more than they used to,” said Olfson. Unfortunately, those figures only represent the number of prescriptions written in doctors’ offices – not in community health centers, clinics, or other medical centers – which means they could be an underestimation of the actual number of children prescribed antipsychotics in the U.S.
Parents Should Consider Alternative Treatments
Armed with this information, parents should start asking questions about the antipsychotics prescribed to their young children and teens, including whether there are any alternative treatments available. According to Olfson, there are psychosocial interventions like parent management training, which have been shown to reduce disruptive and aggressive behavior in kids, although these options are typically more expensive and take more time. So, what are the implications of the finding that there are alternatives to pharmaceutical drugs for successfully treating kids with disorders like ADHD, but they are relied on far less than antipsychotic medications? It’s simple: Our society is so obsessed with instant gratification that doctors have gotten used to automatically prescribing powerful and potentially harmful antipsychotic drugs to children who show the slightest hint of distraction, and parents are accepting this treatment as a quick fix, without giving so much as a second thought to non-medication treatments.