Decline in Children’s Use of Antipsychotic Medications

Decline in Children's Use of Antipsychotic Medications

The Plunge in Antipsychotic Medication Use in Children: A Triumph of Policies and Education

In a remarkable display of progress, the use of antipsychotic medication in children has undergone a significant drop. This decline can be attributed to a combination of improved policies, education, and safer prescribing practices. According to a recent study, there has been a 43% decrease in antipsychotic prescriptions for Medicaid-enrolled children across 45 states. This remarkable shift is a striking departure from the sharp rise witnessed in the 2000s.

“The decline we observed likely reflects the convergence of multiple state safer-use policies along with educational initiatives and the implementation of quality metrics for safe antipsychotic prescribing,” said Stephen Crystal, director of the Center for Health Services Research at Rutgers Institute for Health, Health Care Policy, and Aging Research (IFH). These positive results are a testament to the collaborative efforts of various states to address concerns regarding safe prescribing practices.

The researchers analyzed data from Medicaid claims between 2008 and 2016, focusing on the off-label usage of antipsychotic medications. The study revealed that their use has declined across different age groups, genders, racial and ethnic backgrounds, as well as foster care status. Prior to this decline, these drugs were commonly prescribed for unapproved conditions, despite being primarily approved by the U.S. Food and Drug Administration (FDA) for treating schizophrenia, irritability associated with autism, bipolar disorder, and Tourette syndrome. It should be noted, however, that they are not approved for attention-deficit/hyperactivity disorder. There are potential serious side effects, including type 2 diabetes and sudden cardiac death.

Despite the reduction in usage, it is important to acknowledge that the majority of antipsychotic use in children remains for off-label purposes. However, the study highlights a positive trend: prescribing practices have become more focused on children with FDA-approved mental health conditions.

“Despite declines in pediatric antipsychotic use, safety concerns remain,” noted Greta Bushnell, a faculty member at the Center for Pharmacoepidemiology and Treatment Science at IFH, who co-authored the study. “Our findings highlight the need for continued focus on the judicious prescribing of antipsychotics in this young population.” Safeguarding the well-being of children should remain a priority in the medical community.

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Further research is needed to fully understand the disparities in antipsychotic use, spanning from inappropriate prescribing to underprescribing, as emphasized by the study authors. The research was supported by the Agency for Healthcare Research and Quality, the U.S. National Institutes of Health, and the National Center for Advancing Translational Sciences.

This groundbreaking research was published in the July issue of Health Affairs, shedding light on the remarkable progress made in the field of pediatric psychotropic medication use.

More information

For additional information on children’s mental disorders, refer to the U.S. Centers for Disease Control and Prevention.

Source: Institute for Health, Health Care Policy and Aging Research at Rutgers University

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