Prescribing of psychotropic medications for children by Australian pediatricians and child psychiatrists.
OBJECTIVE
To describe the pattern of prescribing of psychotropic medications for Australian children.


METHODS
Australia-wide cross-sectional postal survey conducted in 2000.


METHODS
All registered general pediatricians and child and adolescent psychiatrists.


RESULTS
The survey was completed by 435 general pediatricians and 187 child and adolescent psychiatrists (response rates 72% and 70%, respectively). Stimulants and clonidine were the most frequently prescribed medications. Seventy-two percent of practitioners reported that they had prescribed a combination of medications. Frequent combinations included a stimulant and clonidine (64% of pediatricians, 51% of child psychiatrists) and a stimulant and a selective serotonin reuptake inhibitor (SSRI; 29% of pediatricians, 36% of child psychiatrists). Pediatricians were more likely than child psychiatrists to report prescribing clonidine for sleep problems (67% vs 36%). Child psychiatrists were more likely than pediatricians to report prescribing SSRIs (93% vs 75%) and mood stabilizers (45% vs 11%) for depression, and SSRIs (74% vs 50%) and tricyclic antidepressants (37% vs 12%) for obsessive compulsive disorder. Off-label prescribing (indication or age not included in the product information) was reported by 40%. Over 5% of practitioners in this study had prescribed clonidine, methylphenidate, dexamphetamine, and typical neuroleptics for children under 3 years of age.


CONCLUSIONS
A broad range of psychotropic medications are being prescribed for Australian children, with some medication groups being prescribed frequently. Combinations of psychotropic medications are used regularly, and there is some prescribing for very young children. The safety and efficacy of several of the agents prescribed have not been adequately researched in children. There is an urgent need for pediatric psychopharmacology research to inform current prescribing practice.
Efron
Daryl
D
Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia. efrond@cryptic.rch.unimelb.edu.au
Hiscock
Harriet
H
Sewell
Jillian R
JR
Cranswick
Noel E
NE
Vance
Alasdair L A
AL
Tyl
Yvonne
Y
Luk
Ernest S L
ES
D000328:Adult; D001315:Australia; D002665:Child Psychiatry / Q000639:trends*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy; D017277:Drug Approval; D004338:Drug Combinations; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy; D010372:Pediatrics / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011619:Psychotropic Drugs / Q000008:administration & dosage*; D012893:Sleep Wake Disorders / Q000188:drug therapy
D004338:Drug Combinations; D011619:Psychotropic Drugs