A national study conducted by PolicyLab at The Children's Hospital of Philadelphia shows an increased use of powerful antipsychotic drugs to treat publicly insured children over the last decade. The study found a 62 percent increase in the number of Medicaid-enrolled children ages 3 to 18 taking antipsychotics, reaching a total of 354,000 children by 2007.
Increased antipsychotic use was observed across a wide range of mental health diagnoses, and was particularly high for children with ADHD or similar disorders, although the FDA has not approved the drugs to treat these conditions in children. In total, 65 percent of children prescribed antipsychotics in 2007 were using the drugs "off-label," or without FDA safety and efficacy data to support their use to treat young patients.
The PolicyLab study is the second recent investigation to focus on the use of antipsychotic drug use in children, and is the largest of its kind to date, representing 35 percent of children in the country.
The frequent off-label use of antipsychotics has raised concern among many health care providers, especially in light of evidence linking antipsychotics with an increased risk of serious metabolic side effects in children, including weight gain and diabetes. The researchers note that the increase in antipsychotic use is due to in part to an overall increase in the number of mental health diagnoses assigned to children. Researchers found a 28 percent increase in the number of children with a mental health diagnosis, but this alone did not account for the spike in prescriptions.
While schizophrenia, bipolar disorder, and autism were the most likely diagnoses to result in an antipsychotic prescription, children with these disorders did not make up the majority of antipsychotic users. Children with ADHD and those who were diagnosed with 3 or more concurrent mental health disorders made up the largest group of children taking antipsychotics. In 2007, 50 percent of children taking antipsychotics had a diagnosis of ADHD, and 14 percent had ADHD as their only diagnosis..