NIH: Boys More Likely to Be On Prescription Antipsychotics Than Girls

By Emily Richards | July 6, 2015 | 4:31pm EDT


(AP photo)

( “Boys are more likely than girls to receive a prescription for antipsychotic medication regardless of age,” according to a study funded by the National Institutes of Health (NIH) and published July 1 in JAMA Psychiatry.

This study, done by Mark Olfson, M.D., of Columbia Psychiatry, Marissa King, Ph.D., of Yale, and Michael Schoenbaum, Ph.D., of the National Institute of Mental Health (NIMH), looked at prescription data from 2006 to 2010 from the IMS LifeLink LRx Longitudinal Prescription database, which includes 63 percent of all outpatient prescriptions in the U.S.  

The prescription data showed that even very young boys were medicated at more than twice the rate of girls their age.

In 2010, 0.16 percent of boys between the ages of 1 and 6 received an antipsychotic prescription compared to only .06 percent of girls the same age.

The same pattern was seen in children aged 7-to-12: 1.2 percent of boys were on prescription antipsychotics compared to 0.44 percent for girls.

Although “the highest rate of antipsychotic treatment was in adolescent boys,” researchers noted that the gap narrowed for the 13-to-18 age group, with 1.42 percent of boys and 0.95 percent of girls on prescription antipsychotics.

It was not until the study subjects reached young adulthood that the rate of medication became comparable, with 0.88 percent of males aged 19-to-24 and 0.81 percent of similarly aged females taking prescription antipsychotics, mostly anti-depressants.

The study found that medication to treat Attention Deficit Hyperactivity Disorder (ADHD) was the most commonly prescribed antipsychotic for children under 18. “This sex difference is consistent with the known male predominance of ADHD and other disruptive behavior disorders during childhood and adolescence,” the study stated.

Researchers also found that antipsychotic use increased with age for all children. Starting at 0.11 percent for ages 1-to-6, it increased to 0.80 percent for ages 7-to-12 and 1.19 percent for 13-to-18-year-olds before finally dropping to 0.84 percent for those aged 19-to-24.

While the U.S. Food and Drug Administration (FDA) has approved the use of antipsychotics for children with certain disorders-- mainly bipolar disorder, autism, and psychosis/schizophrenia-- researchers found that “most office visits by children and adolescents that involve antipsychotic treatment do not include  one of these clinical diagnoses,” adding that “the national prevalence of antipsychotic use by young people is not known.”

Antipsychotics are also being prescribed to young people for “off-label purposes” that are not FDA approved, according to the NIH study.

“For example, maladaptive aggression is common in ADHD, and clinical trial data suggest that at least one antipsychotic, risperidone, when used with stimulants, can help reduce aggression in ADHD,” the study stated.

“To date, FDA has not approved the use of any antipsychotic for ADHD, making its use for this diagnosis off-label. In the current study, the combination of peak use of antipsychotics in adolescent boys and the diagnoses associated with prescriptions (often ADHD) suggest that these medications are being used to treat developmentally limited impulsivity and aggression rather than psychosis.”

“No prior study has had the data to look at age patterns in antipsychotic use among children the way we do here,” said Schoenbaum, senior advisor for mental health services, epidemiology and economics at NIMH.

“Antipsychotics should be prescribed with care,” he continued. “They can adversely affect both physical and neurological function and some of their adverse effects can persist even after the medication is stopped.”

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