Children's prescriptions for antipsychotic medicine double in 20 years

Child prescriptions for powerful anti-psychotic drugs have doubled in 20 years with children as young as THREE getting them for reasons like autism and ADHD, ‘worrying’ study finds

  • Watchdog NICE approved the use of some antipsychotics in under 18’s
  • But researchers found they are prescribed for an increasing range of reasons
  • Twice as many boys as girls received the prescriptions for almost every year
  • The findings demonstrate a ‘concerning trend’, experts warn

Children’s prescriptions for antipsychotic medicines have doubled in the last 20 years, a study found.

The drugs, which have a tranquillising effect, are typically used in adults to treat major mental illnesses, such as schizophrenia.

NHS watchdog NICE approved the use of some antipsychotics in under 18s with psychosis or with severely aggressive behaviour from a conduct disorder.

But researchers found they are also regularly dished out for an increasingly broad range of reasons – including autism and ADHD – to children as young as three.

A team from the University of Manchester’s Centre for Women’s Mental Health examined primary care records of 7.2 million youngsters, aged 3 to 18, registered at GP surgeries between 2000 to 2019

They described the trend as ‘worrying’, adding further research is urgently needed into the safety of these medications for children.

A team from the University of Manchester’s Centre for Women’s Mental Health examined primary care records of 7.2million youngsters, aged 3 to 18, registered at GP surgeries between 2000 to 2019.

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The overall percentage prescribed antipsychotics was relatively small – 0.06 per cent in 2000 and 0.11 per cent in 2019 – but rising every year.

Each age group saw rises, with boys and older children, aged 15 to 18, more likely to be prescribed antipsychotics, such as risperidone and aripiprazole, than girls and younger children.

Twice as many boys as girls received antipsychotic prescriptions for almost every year, with boys more likely to be diagnosed with autism, according to the findings published in Lancet Psychiatry.

Children living in deprived areas had a greater chance of being prescribed an older class of antipsychotics which have been linked to side effects such as movement disorders like Parkinson’s, they found.

Dr Matthias Pierce, who jointly lead the study, said the findings demonstrate ‘a concerning trend in antipsychotic prescribing in children and adolescents’.

He said the increase in prescriptions among children had happened steadily, suggesting it was not linked to changes to prescribing guidelines.

More information is needed on the potential effects of regular use of these drugs among children and their developing minds, he said.

‘We do not think the changes in prescribing necessarily relate to changes in clinical need, rather, it may be more likely to reflect changes in prescribing practice by clinicians,’ he said.

‘We need more information on the conditions that these are being prescribed for and what other options might be available that are preferable. 

‘Then we need more research into the effects of these drugs as there has been little to date.’

Professor Emily Simonoff, of the Institute of Psychiatry Psychology & Neuroscience at King’s College London, said the rise would come as no surprise to clinicians.

She said there was ‘good evidence for their benefits for other conditions such as irritability in autism spectrum disorder’ and that they often formed part of a wider treatment plan including psychological or behavioural interventions.

She said: ‘This study was not able to determine whether such recommendations were being followed or medication was being used on its own.

‘The authors point to longer duration of prescribing and rightly highlight the need for high-quality, longer-term studies on efficacy and, most importantly adverse effects. This should be a research priority.’

There has been a widespread increase in the number of under 18s suffering from mental health conditions in recent years.

NHS Digital figures show the number referred for mental health treatment on the NHS reached 1,169,515 in 2021-22. 

An NHS spokesperson said: ‘The NHS is treating an increasing number of children and adolescents with mental health conditions with around 175,000 more children and young people receiving NHS funded support than before the pandemic thanks to initiatives such as mental health teams in schools to provide immediate support to pupils.

‘For people with a learning disability or autism, the number of antipsychotics prescribed has actually fallen each year since 2017 thanks to NHS England’s Stopping Over Medication of People with a learning disability or autism campaign, and clinicians should only prescribe medication where appropriate and in line with NICE clinical guidance and alongside other therapies.’ 

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