Antipsychotics Too Often Prescribed For Aggression In Children

The headline above comes from a July 1, 2015, news story on the National Public Radio website. The story is based on a study published in JAMA Psychiatry also on July 1st. The NPR article begins with the warning, “Powerful antipsychotic medications are being used to treat children and teenagers with ADHD, aggression and behavior problems, a study finds, even though safer treatments are available and should be used first.”

The rate of usage of these types of drugs has significantly increased over the years and there is a concern that many children are being needlessly medicated and subjected to serious side effects. Many antipsychotic drugs, which were created for use with serious mental disorder such as schizophrenia and bi-polar disorder, are being used for things not approved for such as ADHD and aggressive behavior.

Mark Olfson, a professor of psychiatry at Columbia University who led the JAMA study, commented in the NPR article, “There’s been concern that these medications have been overused, particularly in young children. Guidelines and clinical wisdom suggest that you really should be using a high degree of caution and only using them when other treatments have failed, as a last resort.”

One of the issues pointed out by Olfson in the study was that many of the prescriptions for these powerful drugs were given by general practitioners with little testing, and without considering other alternatives first. “The results suggest that greater access is needed for child and adolescent psychiatric services as well as psychosocial services for young people who present with disruptive behaviors that appear to be common clinical targets,” he said. “A number of effective psychosocial treatments exist for impulsive aggression including interventions that emphasize anger control management and problem solving skills, but few children and their families are receiving them.”

Christof Correll, a professor of psychiatry at Hofstra North Shore-Long Island Jewish School of Medicine, who wrote an editorial to accompany the JAMA article stated, “Behavior modification and family treatment is something that should always come first, but less than one quarter of children and teens are getting that.” He continued, “Physicians use these medications too fast.”

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