Children’s prescriptions for antipsychotics have doubled in the past 20 years, a study finds.
The drugs, which have a sedative effect, are usually used in adults to treat serious mental illnesses, such as schizophrenia.
NHS watchdog NICE has approved the use of some antipsychotics in young people under the age of 18 with psychosis or severe aggressive behavior due to a conduct disorder.
But researchers found they’re also regularly handed out for an increasingly wide variety of reasons — including autism and ADHD — to kids as young as three.
A team from the University of Manchester’s Center for Women’s Mental Health examined the primary care records of 7.2 million young people aged 3 to 18 registered with GP practices between 2000 and 2019
They describe the trend as “worrying” and add that more research is urgently needed on the safety of these drugs for children.
A team from the University of Manchester’s Center for Women’s Mental Health examined the primary care records of 7.2 million young people aged 3 to 18 who were registered with GP practices between 2000 and 2019.
The overall rate of antipsychotics prescribed was relatively small — 0.06 percent in 2000 and 0.11 percent in 2019 — but is rising every year.
Each age group saw increases, with boys and older children aged 15 to 18 being prescribed antipsychotics, such as risperidone and aripiprazole, more often than girls and younger children.
Nearly every year, twice as many boys as girls were prescribed antipsychotics, with boys more likely to be diagnosed with autism, according to findings published in Lancet Psychiatry.
Children living in underserved areas were more likely to be prescribed an older class of antipsychotic drugs that have been associated with side effects such as movement disorders such as Parkinson’s, they found.
Dr. Matthias Pierce, who co-led the study, said the findings “show a worrying trend in antipsychotic prescribing among children and adolescents.”
He said the increase in prescriptions among children had been steady, suggesting it was not linked to changes in prescribing guidelines.
More information is needed about the potential effects of regular use of these drugs on children and their developing minds, he said.
“We don’t think the changes in prescribing are necessarily related to changes in clinical need, but rather reflect changes in prescribing practice by clinicians,” he said.
“We need more information about the conditions for which they are prescribed and what other options may be preferable.
‘Then we need more research into the effects of these drugs, because little has happened so far.’
Professor Emily Simonoff, from the Institute of Psychiatry Psychology & Neuroscience at King’s College London, said the increase would come as no surprise to clinicians.
She said there was “good evidence of their benefits for other conditions such as irritability in autism spectrum disorder” and that they were often part of a broader treatment plan, including psychological or behavioral interventions.
She said: ‘This study was unable to determine whether such recommendations were followed or whether medication alone was used.
‘The authors point to a longer duration of prescription and rightly emphasize the need for high-quality, longer-term studies of efficacy and especially side effects. This should be a research priority.’
The number of young people under the age of 18 with psychological problems has increased sharply in recent years.
NHS Digital figures show that the number of referrals for mental health care 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 illness, with around 175,000 more children and young people receiving NHS-funded support than before the pandemic, thanks to initiatives such as school mental health teams to provide immediate support to students.
“For people with learning disabilities or autism, the number of antipsychotics prescribed has fallen every year since 2017 thanks to the NHS England campaign Stopping Over Medication of People with a learning disability or autism. with NICE clinical guidance and alongside other therapies.”
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