Prescriptions for antipsychotic medications written for children and adolescents has grown significantly in recent years, and two thirds of them are written for off-label indications, raising questions about whether the use of these drugs among children is appropriate.
“It’s concerning that such a high proportion of pediatric patients were taking AAPs (atypical antipsychotic drugs) off-label, and that a number of children are exposed to AAP side effects such as metabolic syndrome and diabetes, while the drugs’ effectiveness on their psychiatric condition may not have been well established,” said Minji Sohn, PhD, co-author of analysis of outpatient data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey.
AAPs include Risperdal, known generically as risperidone, which is approved to treat children and adults with schizophrenia, bipolar disorder and irritability with autism. It is also often prescribed to treat behavioral problems including ADHD and Tourette’s syndrome.
Researchers found that between 2007 and 2010, the most common mental disorder among young patients taking AAPs was ADHD, making up 24 percent of total pediatric AAP prescriptions.
Sohn and colleagues say that the uncertainties around the effectiveness and safety of AAPs raises concerns with off-label uses of the drugs. Concerns are even greater considering these drugs are more and more being prescribed to pediatric patients. A Medicaid study has shown that between 1996 and 2001, AAP use in children and adolescents increased 1.5-fold to 3-fold.
Children can be more susceptible to or experience different side effects from medication than adults. For example, Risperdal has been shown to increase levels of prolactin, the hormone that causes pregnant women to lactate. This can cause adolescent boys to grow breasts, a condition known as gynecomastia.
Source: Contemporary Pediatrics