Trends in the Use of Typical and Atypical Antipsychotics in Children and Adolescents
Nick C. Patel Pharm.D., Ph.D., M. Lynn Crismon Pharm.D. Corresponding Author Contact Information, E-mail The Corresponding Author, Kimberly Hoagwood Ph.D., Michael T. Johnsrud Ph.D., Karen L. Rascati Ph.D., James P. Wilson Pharm.D., Ph.D., Peter S. Jensen M.D.
Dr. Patel is with the Departments of Pharmacy Practice and Psychiatry, University of Cincinnati; Drs. Crismon, Rascati, Wilson, and Johnsrud are with the Center for Pharmacoeconomic Studies, Divisions of Pharmacy Practice and Administration, The University of Texas at Austin; and Drs. Hoagwood and Jensen are with the Department of Psychiatry, Columbia University, New York
Accepted 4 January 2005. Available online 1 November 2009.
To estimate prevalence rates of antipsychotic use in children and adolescents from 1996 to 2001 in three state Medicaid programs (midwestern [MM], southern [SM], and western [WM]) and one private managed care organization (MCO).
Prescription claims were used to evaluate antipsychotic prevalence, defined as the number of children and adolescents up to the age of 19 years with at least one prescription claim for an antipsychotic per 1,000 enrolled youths.
From 1996 to 2001, the prevalence of total antipsychotic use increased in each program (MM: 4.7 to 14.3 per 1,000; SM: 6.3 to 15.5; WM: 4.5 to 6.9; and MCO: 1.5 to 3.4). Typical antipsychotic use decreased (MM: 3.7 to 2.0 per 1,000; SM: 4.6 to 1.5; WM: 4.4 to 1.3; and MCO: 1.2 to 0.9), while atypical antipsychotic use dramatically increased (MM: 1.4 to 13.1 per 1,000; SM: 2.5 to 14.9; WM: 0.3 to 6.2; and MCO: 0.4 to 2.7).
The increased prevalence of antipsychotic use in children and adolescents from 1996 to 2001 was attributed to increased use of atypical antipsychotics. Given the limited data with atypical antipsychotics in youths, this emphasizes the need for additional studies of these agents and other treatment modalities in this population.
Key Words: antipsychotics; pharmacoepidemiology
Total and Antipsychotic Subclass Prevalence
Age-Specific Prevalence of Antipsychotic Use
Gender-Specific Prevalence of Antipsychotic Use
Geographic and Payer System Variations in Antipsychotic Prescribing
Antipsychotic Prevalence Findings
Geographic and Payer System Variation Findings
Clinical Implications of drugs
Metabolic side effects of atypical antipsychotics in children: a literature review.
Fedorowicz VJ, Fombonne E
McGill University, Montreal Children's Hospital, Montreal, QC, Canada H32 1P2.
Journal of Psychopharmacology (Oxford, England) [2005, 19(5):533-50]
Type: Journal Article, Meta-Analysis, Review
The objective of this review is to summarize the data about metabolic side effects of atypical antipsychotics in children. Original research articles about side effects of atypical antipsychotics used in children were reviewed. The data was obtained mainly through Medline searches, identifying articles focusing on the use of atypical antipsychotics in children. Forty studies that addressed the issue of metabolic side effects were selected. The use of atypical antipsychotics in children has been consistently associated with weight gain and moderate prolactin elevation, while only a few case reports address the issue of glucose dysregulation and dyslipidaemia. The risk of weight gain and hyperprolactinaemia might be higher in younger children. Other risk factors have also been associated with antipsychotic-induced metabolic disturbances. These changes seem to be reversible, at least in some cases. Metabolic side effects of atypical antipsychotics could lead to serious complications in children who are prescribed these medications. Serious considerations should be given before initiating treatment and consistent clinical monitoring is essential. More research is needed, especially regarding glucose dysregulation and dyslipidaemia.