The proportion of children and young people prescribed antipsychotics in England has nearly doubled in just two decades, prompting concern among some experts.
The powerful drugs are often used to treat major mental illnesses, such as schizophrenia, in adults. They can be associated with serious side effects such as sexual dysfunction, infertility, and weight gain leading to diabetes.
The National Institute for Clinical Excellence (Nice), the drugs regulator, approves the use of some antipsychotics for children with psychosis or with severely aggressive behaviour from a disorder.
However, a study by the University of Manchester suggests they are being prescribed for a much broader range of conditions, the most common being autism. The research was published in The Lancet Psychiatry.
Researchers examined the records of 7.2 million children and adolescents, aged three to 18, registered at selected English general practices over the period 2000 to 2019.
Although the overall percentage who were prescribed antipsychotics was relatively small, it almost doubled from 0.06% in 2000 to 0.11% in 2019.
The researchers said the increasing use of antipsychotics was worrying given that their safety in children, who are still rapidly developing, had not been fully established.
Dr Matthias Pierce, senior research fellow at the University of Manchester’s Centre for Women’s Mental Health, who jointly led the study, said: “This study demonstrates a concerning trend in antipsychotic prescribing in children and adolescents. We do not think the changes in prescribing necessarily relate to changes in clinical need; rather, it may be more likely to reflect changes in prescribing practice by clinicians.
“However, this study will help clinicians to evaluate the prescribing of antipsychotics to children more fully and will encourage them to consider better access to alternatives.”
The study’s senior author, Prof Kathryn Abel of the University of Manchester, said: “Broadening use of antipsychotics in developing young people begs questions about their safety over time and demands more research on this topic.”
The study also found that boys and older children – aged 15 to 18 – were more likely to be prescribed antipsychotics than girls and younger children.
Emily Simonoff, professor of child and adolescent psychiatry at the Institute of Psychiatry Psychology & Neuroscience, King’s College London, who was not involved in the study, said there was emerging evidence of the benefits of this kind of medication for a range of different conditions.
She added: “Indeed, the term ‘antipsychotics’ is not helpful either for clinicians or the wider public. It describes the way in which this class of medication was first used, rather than their mode of action. This could inadvertently lead people to consider any use that is not for a psychotic disorder to be unwarranted.
“This is not the case, and there is good evidence for their benefits for other conditions such as irritability in autism spectrum disorder.”
