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Antipsychotic Use Declined in Young Children From 2009 to 2017

While there was a shift toward evidence-based indications, majority of use remains off-label

FRIDAY, Nov. 13, 2020 (HealthDay News) — Among privately insured young children, antipsychotic use declined from 2009 to 2017, according to a study published online Oct. 19 in the Journal of the American Academy of Child & Adolescent Psychiatry.

Greta A. Bushnell, Ph.D., from Rutgers University in New Brunswick, New Jersey, and colleagues used data from a nationwide commercial claims database (2007 to 2017) to examine trends in annual antipsychotic medication use by privately insured U.S. young children (ages 2 to 7 years).

The researchers found that annual antipsychotic use in young children was 0.27 percent in 2007, peaked at 0.29 percent in 2009, and significantly declined to 0.17 percent by 2017 (linear trend: −0.017 percent per year). Boys had higher antipsychotic use than girls. More antipsychotic users received a mental disorder diagnosis in 2017 (89 percent) than 2009 (86 percent), with the most common clinical diagnoses being pervasive developmental disorder (2009: 27 percent; 2017: 38 percent), conduct or disruptive behavior disorder (2009: 15 percent; 2017: 21 percent), and attention-deficit/hyperactivity disorder (2009: 24 percent; 2017: 18 percent). In 2017, 32 percent of antipsychotic users had four or more psychotherapy claims, 43 percent had a psychiatrist visit, and the majority used another psychotropic medication, most commonly a stimulant (boys: 57 percent; girls: 50 percent).

“Despite continued prescribing, there is limited evidence for the efficacy of antipsychotics for conduct or disruptive behavior disorders in very young children and the long-term outcomes remain poorly understood,” Bushnell said in a statement.

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