Clinician's Digest II


The Antipsychotic Epidemic

January/February 2013


An alarming number of children and adolescents who walk into a psychiatrist’s office in the United States each year walk out with prescriptions for powerful antipsychotic drug medications. According to data from a large national survey published in the Archives of General Psychiatry, these drugs are prescribed by psychiatrists to a third of the children and adolescents they see.

More than other psychotropic medications, antipsychotics are associated with increased risk of significant cardiac and metabolic problems, such as hypertension, obesity, and diabetes. These long-term effects may represent acceptable risks when balanced against the devastating functional deficits of severe mental illnesses, such as schizophrenia and bipolar disorder, which the drugs were intended to treat. However, the study researchers, led by Mark Olfson of Columbia University, discovered that in nearly 90 percent of the cases, the drugs are being used “off label” to treat conditions for which they’ve never been approved.

Data suggest that the most common reasons the drugs are being prescribed is for disruptive behavior disorders like AD/HD and oppositional defiant disorder. Meanwhile, there’s minimal evidence to support the efficacy of using such powerful medications for these conditions. “They’re approved for schizophrenia and bipolar disorder and irritability with autism,” Olfson told Reuters. “None of them are approved for use with AD/HD.” To make matters worse, little is…

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