DepartmentPharmacology Continuing EducationAntipsychotic Medication Prescribing Trends in Children and Adolescents
Section snippets
Antipsychotic Medications and Their Adverse Effects
The FDA has approved the use of select antipsychotic medications for children and adolescents for treatment of severe conduct problems that are resistant to other forms of treatment. Specific child psychiatric disorders include Tourette’s syndrome and behavioral symptoms associated with autistic disorder, childhood schizophrenia, and bipolar disorder (Crystal et al., 2009, Pathak et al., 2010). Medications approved for pediatric treatment of these disorders include haloperidol (Haldol),
Possible Reasons for the Rising Trend in Antipsychotic Use
Many hypotheses have been generated to explain the increased use of antipsychotic medications in children and adolescents. Some of these explanations are described below.
Implications for Pediatric Health Care Providers
Increasing consensus exists that antipsychotic medication should be the treatment of last resort, after parenting skills training and other behavioral treatments have been tried and have failed (Gleason et al., 2007). Many of the causes of children’s aggressive or disruptive behaviors are linked to family relationships and stressful, unpredictable home environments, which also may be violent and aggressive (National Research Council and the Institute of Medicine, 2009). Under these situations,
Conclusions
Although an increase in the off-label use of antipsychotic medications in children and adolescents has occurred, no standardized oversight exists to guide such use. Close monitoring in collaboration with a qualified mental health provider is needed to ensure safe prescribing practices. Given the significant adverse effects of antipsychotic medications and our limited knowledge of their long-term effects on children’s health, open communication with parents or legal guardians about the potential
Joyce Nolan Harrison, Medical Director, Community Child Psychiatry Programs, and Assistant Professor, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.
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Cited by (0)
Joyce Nolan Harrison, Medical Director, Community Child Psychiatry Programs, and Assistant Professor, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.
Fallon Cluxton-Keller, NIMH Postdoctoral Fellow, Johns Hopkins University Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD.
Deborah Gross, Leonard and Helen Stulman Professor in Mental Health and Psychiatric Nursing, Johns Hopkins University School of Nursing, Baltimore, MD.
Conflicts of interest: None to report.