title: Outpatient treatment of children and adolescents with antipsychotic drugs in Croatia.
abstract: BACKGROUND
  A large increase in the use of atypical antipsychotics (AAPs) in the Western developed countries has been reported. Patterns of antipsychotic therapy and the extent of use of AAPs for youth outside of the developed world are lacking.
  
  
  OBJECTIVE
  To evaluate patterns of antipsychotic treatment of pediatric outpatients in Croatia, including the rate of AAP use.
  
  
  METHODS
  Retrospective analysis of outpatient visits to child psychiatrists by persons aged 18 and younger that included prescription of antipsychotics. Antipsychotic treatment data were identified by frequency, medication class, subclass and drug entity and were analyzed in relation to age group, gender and psychiatric diagnosis.
  
  
  RESULTS
  Overall, 1.3% (106/7953) of pediatric outpatients received antipsychotic therapy during the study period. Antipsychotic treatment was significantly more common in boys and in adolescents. AAPs (80.1%) were significantly more often prescribed than typical antipsychotics (19.9%) (t = 7.76; P < 0.01). In all diagnostic categories (behavior disorders, pervasive developmental disorders and mental retardation, psychotic disorders, mood and tic disorders), the treatment with AAPs was more frequent than typical antipsychotics (χ(2) = 9.92, df = 4, P < 0.05). AAPs were used as monotherapy in 62.2% of outpatients. Off-label prescribing was found in 52.9% of young patients who had received AAPs.
  
  
  CONCLUSIONS
  AAPs comprise most of the antipsychotic medications prescribed to pediatric outpatients in Croatia in all diagnostic categories, reflecting trends in other countries. Unfortunately, such practice occurs in the absence of supporting data about long-term safety and in spite of the lack of evidence regarding their efficacy in some indications.
authors.affiliation: Psychiatric Hospital for Children and Youth, Zagreb, Croatia. vlatka.boricevic@zg.t-com.hr
authors.forename: Vlatka Boričević
authors.initials: VB
authors.lastname: Maršanić
authors.forename: Katarina
authors.initials: K
authors.lastname: Dodig-Ćurković
authors.forename: Zoran
authors.initials: Z
authors.lastname: Juretić
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D017523:Croatia; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D056687:Off-Label Use; D011618:Psychotic Disorders / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D014150:Antipsychotic Agents