A research team set out to investigate the epidemiologic features of antibiotic prescribing to patients under the age of 18 by GPs (general practitioners, primary care doctors) in Great Britain. They gathered data from the UK General Practice Research Database, involving 384 participating general practices, to identify how many child/adolescent patients were prescribed at least one antipsychotic drug between the beginning of 1992 to the end of 2005. They calculated age-specific prevalences and incidences of antipsychotic prescribing.

You can read about this in the journal Pediatrics.

The researchers found that:

— In 1992 there were 0.39 users per 1,000 patient-years

— In 2005 there were 0.77 users per 1,000 patient-years

— Prescribing prevalence for 7-12 year-old patients nearly tripped between start 1992 to end 2005, from 0.23 users per 1,000 patient-years to 0.61 users per 1,000 patient-years.

— Atypical antipsychotic prescribing rose 60-fold during the same period, from 0.01 users per 1,000 patient-years to 0.61 users per 1,000 patient-years.

— Typical antipsychotic prescribing fell from 0.44 users per 1,000 patient-years in year 2,000 to 0.18 users per 1,000 patient-years in 2005.

Although incidences for typical and atypical antipsychotics showed trends similar to those of the respective prevalences “the overall incidence (number of new starters) for all antipsychotics was relatively stable between 1992 and 2005, which suggests that patients remain on treatment longer. ” the researchers wrote.

The researchers concluded that the overall prevalence of antipsychotics nearly doubled during 1992-2005. The increase in the USA during the same period was much greater. Despite lack of conclusive evidence that atypical antipsychotic drugs are superior to older conventional antipsychotics the prescribing of them has increased. The scientists say more research is needed to find out how efficacious and safe these drugs are for children and adolescents.

According to some US newspapers today (Associated Press) children in the United States are prescribed antipsychotic drugs at approximately six times the rate of UK children. Many report that both US and UK kids are probably being over-prescribed.

Most commonly used medications are for treating ADHD (attention deficit hyperactive disorder) and Autism.

Possible reasons for higher US rates, compared to the UK:

1. Prescription drug advertising to non-health care professionals is not allowed in the UK, while it is in the USA. Perhaps US consumers are more aware of available prescription drugs and influence their doctors’ prescribing behavior.

2. The UK has a universal health care system which encourages doctors to keep prescription rates low.

3. UK doctors tend to be more conservative than their American counterparts about prescribing psychiatric drugs (quote from Associated Press, Wayne Ray, Vanderbilt University researcher).

“Epidemiologic Features of Antipsychotic Prescribing to Children and Adolescents in Primary Care in the United Kingdom.
Fariz Rani, BPharm, Macey L. Murray, BSc, Patrick J. Byrne, FRCPsych and Ian C. K. Wong, PhD
PEDIATRICS Vol. 121 No. 5 May 2008, pp. 1002-1009 (doi:10.1542/peds.2007-2008)
Click here to view Abstract online

Sources – Pediatrics, AP, BBC and American Academy of Pediatrics.

Written by – Christian Nordqvist