Article

Trends in the use of typical and atypical antipsychotics in children and adolescents

Department of Pharmacy Practice, University of Cincinnati, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 6.35). 07/2005; 44(6):548-56. DOI: 10.1097/01.chi.0000157543.74509.c8
Source: PubMed

ABSTRACT To estimate prevalence rates of antipsychotic use in children and adolescents from 1996 to 2001 in three state Medicaid programs (midwestern [MM], southern [SM], and western [WM]) and one private managed care organization (MCO).
Prescription claims were used to evaluate antipsychotic prevalence, defined as the number of children and adolescents up to the age of 19 years with at least one prescription claim for an antipsychotic per 1,000 enrolled youths.
From 1996 to 2001, the prevalence of total antipsychotic use increased in each program (MM: 4.7 to 14.3 per 1,000; SM: 6.3 to 15.5; WM: 4.5 to 6.9; and MCO: 1.5 to 3.4). Typical antipsychotic use decreased (MM: 3.7 to 2.0 per 1,000; SM: 4.6 to 1.5; WM: 4.4 to 1.3; and MCO: 1.2 to 0.9), while atypical antipsychotic use dramatically increased (MM: 1.4 to 13.1 per 1,000; SM: 2.5 to 14.9; WM: 0.3 to 6.2; and MCO: 0.4 to 2.7).
The increased prevalence of antipsychotic use in children and adolescents from 1996 to 2001 was attributed to increased use of atypical antipsychotics. Given the limited data with atypical antipsychotics in youths, this emphasizes the need for additional studies of these agents and other treatment modalities in this population.

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    • "It has indications for the treatment of schizophrenia in adolescents aged 13–17 years, for the short-term treatment of acute manic or mixed episodes associated with bipolar I disorder in children and adolescents aged 10–17 years, and irritability associated with autism in children and adolescents 5–16 years of age. In one large study sample of children and adolescents (Patel et al. 2005), risperidone was the most prescribed antipsychotic agent from 1996 to 2000. Therefore, testing risperidone in adolescent animals also has significantly clinical relevance. "
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    ABSTRACT: Risperidone use in children and adolescents for the treatment of various neuropsychiatric disorders (e.g., schizophrenia, autism, disruptive behavior, etc.) has increased substantially in recent decades. However, its long-term effect on the brain and behavioral functions is not well understood. The present study investigated how a short-term risperidone treatment in adolescence impacts antipsychotic response in adulthood in the conditioned avoidance response and phencyclidine (PCP)-induced hyperlocomotion tests. Male adolescent Sprague-Dawley rats (postnatal days [P] 40-44 or 43-48) were first treated with risperidone (0.3, 0.5, or 1.0 mg/kg, subcutaneously (sc)) and tested in the conditioned avoidance or PCP (3.2 mg/kg, sc)-induced hyperlocomotion model daily for five consecutive days. After they became adults (~P 76-80), they were challenged with risperidone (0.3 mg/kg, sc) to assess their sensitivity to risperidone reexposure. A quinpirole (a D2/3 receptor agonist, 1.0 mg/kg, sc)-induced hyperlocomotion test was later conducted to assess the risperidone-induced functional changes in D2 receptor. In the risperidone challenge test in adulthood, adult rats previously treated with risperidone in adolescence made significantly fewer avoidance responses and exhibited significantly lower PCP-induced hyperlocomotion than those previously treated with vehicle. They also appeared to be more hyperactive than the vehicle-pretreated ones in the quinpirole-induced hyperlocomotion test. Prepulse inhibition of acoustic startle or fear-induced 22 kHz ultrasonic vocalizations in adulthood was not altered by adolescence risperidone treatment. Adolescent risperidone exposure induces a long-term increase in behavioral sensitivity to risperidone that persists into adulthood. This long-lasting change might be due to functional upregulation of D2-mediated neurotransmission.
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    • "It has indications for the treatment of schizophrenia in adolescents aged 13–17 years, for the short-term treatment of acute manic or mixed episodes associated with bipolar I disorder in children and adolescents aged 10–17 years, and irritability associated with autism in children and adolescents 5–16 years of age. In one large study sample of children and adolescents (Patel et al. 2005), risperidone was the most prescribed antipsychotic agent from 1996 to 2000. Therefore, testing risperidone in adolescent animals also has significantly clinical relevance. "
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