Clinical Scorecard: Patterns of Antipsychotic Medication Use and Indications in Children: A Nationwide Cohort Analysis from Sweden

At a Glance

Key Highlights

• Incidence of antipsychotic use increased from 0.48 to 1.28 per 1000 persons between 2008 and 2021.
• 64.3% of incident dispensings had a likely indication, with autism spectrum disorder being the most common.
• 81% of dispensings with identifiable indications were off-label, primarily for non-approved conditions.
• Significant increases in use of quetiapine and aripiprazole were noted, especially among adolescent females.
• Marked sex-specific indication patterns were observed, with males treated mainly for ASD and females for anxiety and mood disorders.

Guideline-Based Recommendations

Diagnosis

• Assess indications for antipsychotic use in children and adolescents carefully.

Management

• Consider long-term effectiveness and safety of antipsychotics, especially for off-label use.

Monitoring & Follow-up

• Monitor for efficacy and safety in pediatric populations receiving antipsychotics.

Risks

• Evaluate risks associated with off-label prescribing of antipsychotics.

Patient & Prescribing Data

Children and adolescents in Sweden

High rates of off-label prescribing for conditions without approved treatments.

Clinical Best Practices

• Conduct thorough risk-benefit assessments before prescribing antipsychotics to children.
• Update clinical guidelines to reflect the expanding scope of pediatric antipsychotic prescribing.

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