Rising number of teenagers are being given anti-psychotic drugs, study reveals

• Rising number of children prescribed anti-psychotics to treat ADHD
• That's despite the fact the drugs are not approved to treat the condition
• Columbia University study found number of teens using the drugs rose from 1.10% to 1.19% from 2006 to 2010
• Scientists note that with 74 million under 18s in the US, the small percentages translate to a large number of medicated children  

By Lizzie Parry for MailOnline

Published: 04:32 EST, 13 July 2015 | Updated: 11:46 EST, 13 July 2015

A Columbia University study reveals a growing number of teenagers and young adults are being prescribed anti-psychotic drugs (file image)

A growing number of teenagers and young adults are being prescribed anti-psychotics, a new study has revealed.

In particular, it appears they are being used to treat attention deficit and hyperactivity disorder (ADHD), a condition for which the powerful drugs are not approved in the US.

Scientists at Columbia University in New York found the percentage of teens using anti-psychotics rose from 1.10 per cent in 2006 to 1.19 per cent in 1010.

Use among young adults, aged 19 to 24 rose from 0.69 per cent to 0.84 per cent, the study found.

With around 74 million under 18s in the US, the researchers noted, these small percentages add up to a large number of medicated children. 

'Great caution should be exercised in the use of anti-psychotics, especially for young children,' said lead study author Dr Mark Olfson, a research psychiatrist at Columbia University in New York.

Dr Olfson and colleagues analysed prescription data from 2006, 2008, and 2010 as well as records from 2009 combining pharmacy and medical claims information, Reuters reports.

The records covered prescriptions filled at approximately 60 per cent of all retail pharmacies in the US.

Overall in 2010, approximately 270,000 anti-psychotic prescriptions were dispensed to younger children, 2.14 million to older children, 2.80 million to adolescents, and 1.83 million to young adults, the authors said.

Anti-psychotic drugs include Abilify (aripiprazole), Risperdal (risperidone), Seroquel (quetiapine), Zyprexa (olanzapine) and others.

For younger children, anti-psychotic use declined from 2006 to 2010, the researchers report in the journal JAMA Psychiatry. 

Prescriptions fell from 0.14 per cent to 0.11 per cent for children aged one to six, and from 0.85 per cent to 0.80 per cent for children aged seven to 12.

This is most likely due to increased efforts to curb anti-psychotic use among younger children over concerns about side effects such as weight gain, high cholesterol and uncertainty about the long-term effects of the drugs on the developing nervous system, Dr Olfson said.

Among children 18 and under, the most common reason for anti-psychotics was ADHD, the study found. 

This diagnosis accounted for about 53 per cent of prescriptions for younger children, 60 per cent for older kids, and 35 per cent for teens.

'This is concerning because evidence of anti-psychotics' efficacy for treating a number of behavioural health disorders is lacking,' said Dr Meredith Matone, a research scientist with PolicyLab at the Children's Hospital of Philadelphia.

Anti-psychotics are approved in the US for treatment of psychotic conditions including bipolar disorder and schizophrenia, as well as for easing aggression among cognitively impaired youth, Dr Matone, who wasn't involved in the study, said.

'Increasingly, many youth are receiving these medications to treat behaviour problems in the absence of a more severe psychiatric illness,' she said.

Part of this may be due to who is prescribing the drugs, according to an editorial by Dr Christoph Correll, a psychiatry researcher at the Zucker Hillside Hospital in Glen Oaks, New York and the North Shore-Long Island Jewish Health System.

Out of roughly seven million anti-psychotic prescriptions written for children, adolescents and teens in 2010, only 29 to 39 per cent came from a child and adolescent psychiatrist, he noted in the editorial.

'I was most surprised by the fact that the majority of youth receiving anti-psychotics did not have a mental disorder diagnosis,' Dr Correll told Reuters Health.

Researchers discovered among children 18 and under, the most common reason for anti-psychotics was ADHD. 'This is concerning because evidence of anti-psychotics' efficacy for treating a number of behavioural health disorders is lacking,' said Dr Meredith Matone, from the Children's Hospital of Philadelphia

The study also exposed a gender gap, with prescriptions for boys outpacing girls during elementary, high school and college years.

'The peak use among adolescent boys, who are frequently diagnosed with ADHD and are also treated with stimulants, strongly suggests that anti-psychotics are commonly used to treat impulsive aggression and other behavioural symptoms,' Dr Olfson said.

Before parents agree to start their child on anti-psychotics to manage aggressive behaviour, they should ask about alternative treatments such as anger management, counselling for parents on how to respond to aggression, and other psychosocial options, he said.

'The main takeaway for clinicians and families is that for youth without psychiatric symptoms, alternatives to anti-psychotic treatment should be tried whenever possible,' Dr Correll said.

'When anti-psychotics are used, the lowest risk agents should be used for the shortest time possible.' 

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