Health, Australia (Commonwealth Union) – A recent study conducted by researchers at the University of Adelaide reveals an upward trend in the prescription of antipsychotic drugs to children and adolescents in Australia for non-approved conditions. The research, supported by funding from the Channel 7 Children’s Research Foundation and published in JCPP Advances, analyzed prescribing patterns of antipsychotics to young individuals diagnosed with mental health conditions in 2011 and 2017, utilizing the extensive MedicineInsight general practice database.
The study identified a notable prevalence of off-label prescribing, indicating the administration of drugs for medical conditions not officially approved by regulatory bodies. In Australia, the Therapeutic Goods Administration (TGA) has sanctioned the use of pediatric antipsychotics solely for bipolar disorder, psychoses, and severe self-destructive, disruptive, or aggressive behaviors.
The research findings indicate an increase in the prescription of antipsychotics to children and adolescents from 2011 to 2017, with off-label prescribing rising by 10%, encompassing nearly 80% of all patients prescribed antipsychotics in 2017. Notably, in both years, the primary reason for antipsychotic prescriptions was for depression or anxiety – both considered off-label uses.
University of Adelaide Professor Jon Jureidini, Research Leader of the Robinson Research Institute’s Critical and Ethical Mental Health group, expressed concern over these findings, emphasizing the potential risks and harms associated with the use of antipsychotic drugs in children and adolescents. The study sheds light on the need for careful consideration and monitoring of prescribing practices, highlighting the importance of aligning prescriptions with approved indications to safeguard the well-being of young individuals.
“There are well-known cardiometabolic adverse effects associated with antipsychotics, and studies have shown that paediatric patients develop these symptoms much more rapidly than adults taking these drugs. That puts children at increased risk for the development of metabolic syndrome and diabetes in childhood, and chronic cardiovascular diseases in adulthood.”
The research also delved into the sociodemographic characteristics of individuals receiving off-label antipsychotic prescriptions. Notably, the surge in off-label prescribing was most pronounced among older adolescents aged 15-18 years, individuals residing in regional and remote areas, and those in socioeconomically disadvantaged areas.
A concerning revelation from the study indicates that 70% of children and adolescents prescribed antipsychotics were concurrently prescribed another psychiatric drug during both years under examination. The simultaneous use of multiple psychiatric drugs heightens the risk of adverse events and is generally discouraged in pediatric patients, emphasizing the need for cautious medical practices as indicated by researchers of the study.
Lead author Julie Klau, a PhD candidate in the Critical and Ethical Mental Health research group, highlighted the prevalence of off-label prescribing in children and adolescents. She attributed this phenomenon to the scarcity of studies conducted in this demographic, leading to limited evidence regarding the effectiveness and safety of such prescriptions. The scarcity of data contributes to the infrequency of approvals by the Therapeutic Goods Administration (TGA), underscoring the challenges in establishing comprehensive guidelines for pediatric psychiatric medication use.
“GPs are legally allowed to prescribe off-label but must take extra precautions because of the lack of good evidence. The increase in off-label prescriptions of antipsychotics among vulnerable children is of concern and requires further action.”
The study’s authors underscore the critical importance of delving into the reasons behind the notable prevalence of off-label antipsychotic prescriptions, particularly among socioeconomically disadvantaged children. The urgent call to investigate aims to unravel the factors contributing to this phenomenon and address concerns regarding the simultaneous use of multiple psychiatric drugs in a significant number of children. Understanding these patterns will be vital for developing targeted interventions and refining prescribing practices to better serve the mental health needs of vulnerable pediatric populations. The misuse of many medications has been a key concern for many conditions. New studies can play a key role in forming ways to address these issues.
