Abstract
Over the last decades, an increase in antipsychotic (AP) prescribing and a shift from first-generation antipsychotics (FGA) to second-generation antipsychotics (SGA) among youth have been reported. However, most AP prescriptions for youth are off-label, and there are worrying long-term safety data in youth. The objective of this study was to assess multinational trends in AP use among children and adolescents. A repeated cross-sectional design was applied to cohorts from varied sources from Denmark, Germany, the Netherlands, the United Kingdom (UK) and the United States (US) for calendar years 2005/2006–2012. The annual prevalence of AP use was assessed, stratified by age group, sex and subclass (FGA/SGA). The prevalence of AP use increased from 0.78 to 1.03% in the Netherlands’ data, from 0.26 to 0.48% in the Danish cohort, from 0.23 to 0.32% in the German cohort, and from 0.1 to 0.14% in the UK cohort. In the US cohort, AP use decreased from 0.94 to 0.79%. In the US cohort, nearly all ATP dispensings were for SGA, while among the European cohorts the proportion of SGA dispensings grew to nearly 75% of all AP dispensings. With the exception of the Netherlands, AP use prevalence was highest in 15–19 year-olds. So, from 2005/6 to 2012, AP use prevalence increased in all youth cohorts from European countries and decreased in the US cohort. SGA were favoured in all countries’ cohorts.
Highlights
During the past decades, antipsychotic drugs (AP) have gained popularity as a treatment for psychiatric disorders in young people in most developed countries [1]
AP can be divided in two groups: first generation antipsychotics (FGA) and second-generation antipsychotics (SGA) [2, 3]
Numerous reports from Western countries have described an increase in AP use, especially second-generation (atypical) antipsychotics (SGA), over recent years [1, 13,14,15,16,17]
Summary
Antipsychotic drugs (AP) have gained popularity as a treatment for psychiatric disorders in young people in most developed countries [1]. Ample use of AP drugs has been described in children with a mental handicap and behavioral symptoms [10]. Numerous reports from Western countries have described an increase in AP use, especially SGA, over recent years [1, 13,14,15,16,17]. These studies differ in terms of studied time period, age groups and other methodological features, hampering comparability. While there are some multinational studies comparing antidepressant or ADHD medication use in children and adolescents [18,19,20], updating patterns of AP use across countries and regions is warranted
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