An analysis of routine insurance data from the Barmer GEK statutory health insurance company shows that during the years 2005 to 2012, antipsychotic prescriptions for kids in Germany increased a lot.
The percentage of children and adolescents receiving a prescription for an antipsychotic drug over the course of one calendar year rose from by nearly 50 percent, from 0.23% to 0.32%. The increase was nearly double among 10- to 14-year-olds (from 0.24% to 0.43%) and over 60 percent among 15- to 19-year-olds (from 0.34% to 0.54%). In particular, there was an increase in prescriptions for atypical antipsychotics (from 0.10% to 0.24%). Those numbers are in the middle range for European countries but, as the increasing acts of violence by people invariably on psychiatric medication has shown, low in comparison with figures from the USA. It's not a path they should want to take.
Even more of a concern, since only a small number of antipsychotic drugs have been approved for use in children and adolescents, antipsychotic drugs for those age groups are often given off label. The most commonly prescribed substances were risperidone, pipamperone, quetiapine, and tiapride.
The authors point out that antipsychotic drugs can cause side effects including extrapyramidal motor symptoms (early and tardive dyskinesia, akathisia), weight gain, and hyperlipidemia. The older approved drugs can also have major adverse effects. Thus, the indication for an antipsychotic drug should be determined after careful consideration of the risks and benefits.
Published in Deutsches Ärzteblatt International - Dtsch Arztebl Int 2014; 111(3): 25 – 40.
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