US Kids Use Antipsychotics More Than In The UK

American children take antipsychotics at about six times the rate of children in the UK, according to a comparison based on a study published in Pediatrics.

But does this mean kids in the US are being overtreated? Or are Uk children undertreated? Experts say that’s almost beside the point, because use is rising on both sides of the Atlantic, Reuters reports. And with little long-term safety data, the drugs may be overprescribed for children in both countries, research suggests.

In the study, there were 595 antipsychotic scrips for kids in 1992, or a rate of fewer than four children per 10,000 using the drugs. By 2005, 2,917 scrips were written, or a rate of seven children per 10,000 - a near-doubling, Fariz Rani, a researcher at the University of London’s pharmacy school and the lead author, tells Reuters.

By contrast, an earlier US study found that nearly 45 American children out of 10,000 used the drugs in 2001 versus more than 23 per 10,000 in 1996. There are big differences that could help explain the vastly higher US rate. A recent report in The Lancet suggested the UK’s universal health care system limits prescribing practices there, and noted that direct-to-consumer ads are more common in the US.

The new UK study, involving 1992-2005 health records of more than 16,000 children, is the first large examination of these drugs in UK children, and found the increase was mostly in meds that haven’t been officially approved for kids. They were most commonly prescribed for behavior and conduct disorders, which include attention deficit disorder.

Side effects including weight gain, nervous-system problems and heart trouble have been reported in children using these drugs and there’s little long-term evidence about safety for kids, the study authors said. “This highlights the need for long-term safety investigations and ongoing clinical monitoring,” they wrote, “particularly if the prescribing rate of these medicines continues to rise.”

One of the most commonly used antipsychotics in the UK study were Johnson & Johnson’s Risperdal and Thioridazine, which is sometimes used to treat hyperactivity in attention deficit disorder, although its use decreased after 2000 when a UK safety committee warned of heart-related side effects, the authors said.

In both countries, the issue isn’t simply how many children are getting these drugs, according to David Fassler, a University of Vermont psychiatry professor. “The more important question is whether or not the right kids are getting the most appropriate and effective treatment possible,” he tells Reuters. Fassler, by the way, wasn’t involved in the study.

William Cooper, a Vanderbilt University pediatrician, tells Reuters the study shows the drugs are being used “without full understanding about the risks…I find it really interesting that we’re now seeing increases in other countries besides the U.S., which suggests that the magnitude of this issue is global,” says Cooper, who was a co-author of the 2004 U.S. study.

Hat tip to Pharmagossip