Published online May 1, 2008
PEDIATRICS Vol. 121 No. 5 May 2008, pp. 1002-1009 (doi:10.1542/peds.2007-2008)
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ARTICLE

Epidemiologic Features of Antipsychotic Prescribing to Children and Adolescents in Primary Care in the United Kingdom

Fariz Rani, BPharma,b, Macey L. Murray, BSca,b,c, Patrick J. Byrne, FRCPsychd,e and Ian C. K. Wong, PhDa,b

a Centre for Paediatric Pharmacy Research, School of Pharmacy, University of London, London, England
b Institute of Child Health, University College London, London, England
c Task-force of European Drug Development for the Young (TEDDY)
d Department of Adolescent Psychiatry, Bethlem Royal Hospital, South London, England
e Maudsley National Health Service Trust, Beckenham, England

OBJECTIVE. The goal was to investigate the epidemiologic features of antipsychotic prescribing to children and adolescents in general practice in the United Kingdom.

METHODS. A total of 384 participating general practices from the United Kingdom General Practice Research Database were used to identify patients 0 to 18 years of age who were prescribed ≥1 antipsychotic medication between January 1, 1992, and December 31, 2005. Annual age-specific prevalences and incidences of antipsychotic prescribing were calculated.

RESULTS. The overall prevalence of use of all antipsychotics increased from 1992 (0.39 users per 1000 patient-years) to 2005 (0.77 users per 1000 patient-years). The prescribing prevalence for patients 7 to 12 years of age almost tripled between 1992 (0.23 users per 1000 patient-years) and 2005 (0.61 users per 1000 patient-years). Atypical antipsychotic prescribing increased 60-fold from 1994 (0.01 users per 1000 patient-years) to 2005 (0.61 users per 1000 patient-years). However, typical antipsychotic prescribing decreased significantly from 2000 (0.44 users per 1000 patient-years) to 2005 (0.18 users per 1000 patient-years). The incidences for typical and atypical antipsychotics showed trends similar to those of the respective prevalences. However, the overall incidence (number of new starters) for all antipsychotics was relatively stable between 1992 and 2005, which suggests that patients remain on treatment longer.

CONCLUSIONS. The overall prevalence of antipsychotics almost doubled between 1992 and 2005; however, the rate of increase was much lower than the reported figures in the United States. The prescribing of atypical antipsychotic drugs has increased despite the lack of conclusive evidence showing their superiority over older conventional antipsychotics. Additional investigation is required to evaluate their efficacy and safety in children and adolescents.

Key Words: drug utilization • pharmacoepidemiology • pediatric • antipsychotics

Abbreviations: GPRD—General Practice Research Database • CI—confidence interval

Accepted Sep 17, 2007.


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