Clinical Report: Patterns of Antipsychotic Medication Use in Children
Overview
This study analyzed the incidence and indications of antipsychotic medication use among children and adolescents in Sweden from 2008 to 2021. It found an increase in usage, particularly among adolescent females, with a high proportion of off-label prescriptions.
Background
Antipsychotic medications are prescribed to children and adolescents for various psychiatric conditions, often beyond their approved indications. Understanding the patterns of use and the associated indications is important for assessing the safety and efficacy of these medications in the pediatric population.
Data Highlights
Year
Incidence per 1000 Persons
Risk Ratio (RR)
2008
0.48
-
2021
1.28
1.08 (95% CI 1.05 to 1.11)
Key Findings
24,742 children initiated antipsychotic treatment between 2008 and 2021.
Incidence of antipsychotic use increased from 0.48 to 1.28 per 1000 persons, a cumulative increase of 180%.
Female adolescents showed a more pronounced increase in incidence (284%) compared to males (113%).
64.3% of incident dispensings had a likely identifiable indication, with autism spectrum disorder being the most common (15.4%).
81% of dispensings with identifiable indications were off-label, primarily due to non-approved indications.
Clinical Implications
The rising incidence of antipsychotic use among adolescent females highlights the need for careful evaluation of the long-term safety and effectiveness of these medications.
Conclusion
The study reports an increase in antipsychotic use among children and adolescents in Sweden, particularly off-label, indicating a need for ongoing monitoring and research into their safety and efficacy.
This Neuroscience Grand Rounds session, led by Yasaman Movahedi and Deanna Aghbashian, explores psychosis in adolescence through both clinical and neurocognitive lenses, emphasizing early recognition and multidisciplinary management.
