MONDAY, June 5 (HealthDay News) -- The use of antipsychotic drugs prescribed for children has soared six-fold since the early 1990s, a new report finds.
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The surge appears to be largely due to doctors who prescribe the drugs to treat mental illnesses -- including behavior disorders and mood disorders -- that don't have a psychotic component. In many cases, the U.S. government frowns on such "off-label" treatment, but it is legal.
The report findings are a cause for concern, because it's not clear how the drugs work in children, said study lead author Dr. Mark Olfson, professor of clinical psychiatry at Columbia University College of Physicians & Surgeons.
"They've been used in ways that haven't been as extensively studied and for which they haven't been approved by the FDA (U.S. Food and Drug Administration)," Olfson said. "Whenever the practice gets out in front of the science, there's reason for concern."
Olfson and his colleagues examined figures from annual federal surveys of doctors about their practices. The study findings appear in the June issue of the journal Archives of General Psychiatry.
Based on the survey results, the researchers estimate that the number of office visits by children 20 and younger that included prescriptions for antipsychotic drugs grew from 201,000 in 1993 to 1.2 million in 2002. About 18 percent of visits to psychiatrists resulted in prescriptions for antipsychotic drugs.
Antipsychotic drugs are designed to treat people with psychotic disorders that give them a warped sense of reality. But the study shows that doctors are using them for other purposes for children, including behavior disorders (38 percent) and mood disorders (32 percent).
In some cases, the drugs aren't federally approved for treatment of those conditions, but doctors can still legally prescribe them for "off-label" uses.
Children with behavior disorders may be threatening or intimidating other children, Olfson said. What's more, the decline of psychiatric hospitalization of children is forcing psychiatrists to treat children with more severe symptoms. "Part of it is, also, that there aren't a lot of other alternatives to help with the management of kids who have serious behavioral problems," he said.
But it remains unclear exactly how antipsychotic drugs affect children, said Dr. William Cooper, associate professor of pediatrics at Vanderbilt Children's Hospital, who's familiar with the study's findings.
"For things like attention-deficit disorder, depression and bipolar disorder, the bottom line is we don't know whether they work for those conditions in children, and we don't know what side effects they have in kids," Cooper said.
Some newer antipsychotic medications seem to cause weight gain, diabetes and heart rhythm irregularities, Cooper said.
Still, when psychiatrists "find themselves faced with a child having out-of-control behavior, they may think there's not a lot of other options," he said.
SOURCES: Mark Olfson, M.D., M.P.H., professor of clinical psychiatry, College of Physicians & Surgeons, Columbia University, New York City; William Cooper, M.D., associate professor of pediatrics, Vanderbilt Children's Hospital, Nashville, Tenn.; June 2006, Archives of General Psychiatry
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