ANTIPSYCHOTICS - ABSTRACTS OF ACADEMIC ARTICLES REGARDING THE RISKS OF THESE 'HEAVY DUTY' DRUGS.

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.
Purchase
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.
ABSTRACT
Objective

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).
Method

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.
Results

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).
Conclusions

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
Article Outline

    METHOD
        Data Sources
        Measures
        Data Analysis
    RESULTS
        Population Characteristics
        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
    DISCUSSION
        Antipsychotic Prevalence Findings
        Geographic and Payer System Variation Findings
        Clinical Implications of drugs
  REFERENCES


   
Metabolic side effects of atypical antipsychotics in children: a literature review.
(PMID:16166191)


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

DOI: 10.1177/0269881105056543

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.