Trends in antipsychotic drug utilisation and indication in the paediatric population: a nationwide cohort study in Sweden
By
Karl-Hermann S Kamgang
Bjorn Pasternak
Johan Reutfors
Richeek Pradhan
Viktor Wintzell
June 16, 2026
Clinical Scorecard: Patterns of Antipsychotic Medication Use and Indications in Children: A Nationwide Cohort Analysis from Sweden
At a Glance
Category Detail
Condition Antipsychotic Medication Use in Children Key Mechanisms Dopamine and serotonin receptor modulation Target Population Children and adolescents aged 0-17 years Care Setting Nationwide cohort study
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. Related Resources & Content
