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This study evaluated the prescription trends, patterns and associated factors of antipsychotic medication in children and adolescents. We conducted a retrospective study by using the database of outpatient health insurance files of a psychiatric center in Northern Taiwan from 2004 to 2013. A total of 173,209 outpatient health insurance files were included. The average age of the study patients was 11.3 (±3.9) years. Of all visits of the patients, 13.4% were prescribed antipsychotics. The prescription rate of all antipsychotic medication types in all the outpatients aged ≤18 years increased yearly by 0.6%. The prescription rate of first-generation antipsychotics decreased with an estimated average annual percent change of 5.6% (p < .001). By contrast, the prescription rate of second-generation antipsychotics increased with an estimated average annual percent change of 3.4% (p <.001). Multiple logistic regression analysis was performed to examine clinical factors (age, sex and diagnosis) associated with antipsychotic prescription. After adjusting for other variables, antipsychotic prescription was found to be increased by 1.31 times every year with age and by 1.06 times in the male patients. The patients with diagnoses other than schizophrenia appeared less likely to be prescribed antipsychotics. Antipsychotic medications are being increasingly prescribed to children and adolescents in recent years. T he efficacy and safety of antipsychotics in children and adolescents warrant clinical attention.
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Christian R, Saavedra L, Gaynes BN, Sheitman B, Wines RCM, Jonas DE, Viswanathan M, Ellis AR, Woodell C, Carey TS. Agency for Healthcare Research and Quality U.S. Department of Health and Human Services. (2012). Future Research Needs for First- and Second-Generation Antipsychotics for Children and Young Adults. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK84660/pdf/TOC.pdf
Cohen, D., Raffin, M., Canitano, R., Bodeau, N., Bonnot, O., Périsse, D., … Laurent, C. (2013). Risperidone or aripiprazole in children and adolescents with autism and/or intellectual disability: A Bayesian meta-analysis of efficacy and secondary effects. Research in Autism Spectrum Disorders, 7(1), 167-175.
Cooper, W. O., Arbogast, P. G., Ding, H., Hickson, G. B., Fuchs, D. C., & Ray, W. A. (2006). Trends in Prescribing of Antipsychotic Medications for US Children. Ambulatory Pediatrics, 6(2), 79-83.
Drevets, W. C. (2000). Neuroimaging studies of mood disorders. Biological Psychiatry, 48(8), 813-829.
Driessen, J. C., Baik, S. H., & Zhang, Y. (2016). Trends in Off-Label Use of Second-Generation Antipsychotics in the Medicare Population From 2006 to 2012. Psychiatric Services, 67(8), 898-903.
Egger, H. L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry, 47(3-4), 313-337.
Fountoulakis, Konstantinos N, Nimatoudis, Ioannis, Iacovides, Apostolos, … George. (2004). Off-label indications for atypical antipsychotics: A systematic review. (BioMed Central Ltd.) BioMed Central Ltd.
Harrison, J. N., Cluxton-Keller, F., & Gross, D. (2012). Antipsychotic Medication Prescribing Trends in Children and Adolescents. Journal of Pediatric Health Care, 26(2), 139-145.
Hurley, A. D., Folstein, M., & Lam, N. (2003). Patients with and without intellectual disability seeking outpatient psychiatric services: diagnoses and prescribing pattern. Journal of Intellectual Disability Research, 47(1), 39-50.
Hsu, Y., Chien, I., Tan, H. K., Lin, C., Cheng, S., Chou, Y., & Chou, P. (2013). Trends, correlates, and disease patterns of antipsychotic use among children and adolescents in Taiwan. Social Psychiatry and Psychiatric Epidemiology, 48(12), 1889-1896.
Kalverdijk, L. J., Tobi, H., Van den Berg, P. B., Buiskool, J., Wagenaar, L., Minderaa, R. B., & De Jong-van den Berg, L. T. (2008). Use of Antipsychotic Drugs Among Dutch Youths Between 1997 and 2005. Psychiatric Services, 59(5), 554-560.
Kuehn, B. M. (2010). Studies Shed Light on Risks and Trends in Pediatric Antipsychotic Prescribing. JAMA, 303(19), 1901.
Lao, K. S., Tam, A. W., Wong, I. C., Besag, F. M., Man, K. K., Chui, C. S., & Chan, E. W. (2017). Prescribing trends and indications of antipsychotic medication in Hong Kong from 2004 to 2014: General and vulnerable patient groups. Pharmacoepidemiology and Drug Safety, 26(11), 1387-1394.
Lelliott, P., Paton, C., Harrington, M., Konsolaki, M., Sensky, T., & Okocha, C. (2002). The influence of patient variables on polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients. Psychiatric Bulletin, 26(11), 411-414.
López-Muñoz, F., Shen, W. W., Shinfuku, N., Pae, C., Castle, D. J., Chung, A. K., … Álamo, C. (2014). A Bibliometric Study on Second-generation Antipsychotic Drugs in the Asia–Pacific Region. Journal of Experimental & Clinical Medicine, 6(4), 111-117.
López-Muñoz, F., Shen, W. W., Moreno, R., Molina, J. D., Noriega, C., Pérez-Nieto, M. A., ... & Álamo, C. (2012). International scientific productivity on second-generation antipsychotic drugs in Taiwan: A bibliometric study. Taiwanese Journal of Psychiatry 26(2), 114-129
Maršanić, V. B., Dodig-Ćurković, K., & Juretić, Z. (2011). Outpatient treatment of children and adolescents with antipsychotic drugs in Croatia. Nordic Journal of Psychiatry, 66(1), 2-7.
Martin, A., & Leslie, D. (2003). Trends in Psychotropic Medication Costs for Children and Adolescents, 1997-2000. Archives of Pediatrics & Adolescent Medicine, 157(10), 997.
Olfson, M., Blanco, C., Liu, L., Moreno, C., & Laje, G. (2006). National Trends in the Outpatient Treatment of Children and Adolescents With Antipsychotic Drugs. Archives of General Psychiatry, 63(6), 679.
Patel, N. C., Crismon, M. L., & Shafer, A. (2006). Diagnoses and Antipsychotic Treatment Among Youths in a Public Mental Health System. Annals of Pharmacotherapy, 40(2), 205-211.
Patel, N. C., Crismon, M. L., Hoagwood, K., Johnsrud, M. T., Rascati, K. L., Wilson, J. P., & Jensen, P. S. (2005). Trends in the Use of Typical and Atypical Antipsychotics in Children and Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 44(6), 548-556.
Uchida, H., Suzuki, T., Mamo, D. C., Mulsant, B. H., Tanabe, A., Inagaki, A., … Tomita, M. (2008). Effects of Age and Age of Onset on Prescribed Antipsychotic Dose in Schizophrenia Spectrum Disorders: A Survey of 1,418 Patients in Japan. The American Journal of Geriatric Psychiatry, 16(7), 584-593.
Vitiello, B., Correll, C., Van Zwieten-Boot, B., Zuddas, A., Parellada, M., & Arango, C. (2009). Antipsychotics in children and adolescents: Increasing use, evidence for efficacy and safety concerns. European Neuropsychopharmacology, 19(9), 629-635.
Walkup, J. (2009). Practice Parameter on the Use of Psychotropic Medication in Children and Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 48(9), 961-973.
Zito, J. M., Safer, D. J., DosReis, S., Gardner, J. F., Magder, L., Soeken, K., … Riddle, M. A. (2003). Psychotropic Practice Patterns for Youth. Archives of Pediatrics & Adolescent Medicine, 157(1), 17.