Trends in prescribing of antipsychotic medications for US children

Objective: To identify frequencies of prescribing for antipsychotics among all US children. Methods: Data were drawn from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, which are national samples of health care services rendered to the US population. Survey data were used to determine antipsychotic prescription frequencies for 2-18 year old US children from 1995-2002. Results: During 1995-2002, there were 5 762 193 visits to health providers by US children during which an antipsychotic was prescribed. Almost one third (32.4%) of the prescriptions were associated with visits to nonmental health providers. Fifty-three percent of the prescriptions were for behavioral indications or affective disorders, conditions for which antipsychotics have not been carefully Studied in children. The overall frequency of antipsychotic prescribing increased from 8.6 per 1000 US children in 1995-1996 to 39.4 per 1000 US children in 2001-2002 (rate ratio 4.89, 95% CI, 2.50-9.55). Across all age groups, increases for nonstudied indications were even more pronounced than increases for approved indications. Conclusion: The increase in frequencies of antipsychotic prescribing and the large number of children receiving antipsychotics each year reinforce the urgent need to conduct well-controlled studies of these medications in children.