title: Psychotropic drug prescribing in an Australian specialist child and adolescent eating disorder service: a retrospective study.
abstract: BACKGROUND
  To describe the rates, indications, and adverse effects of psychotropic drug prescription in a specialist tertiary hospital child and adolescent eating disorder service.
  
  
  METHODS
  Retrospective case note study of all active eating disorder patients (N = 115) over the period of treatment from referral to time of study (M = 2 years), covering patient demographics, clinical characteristics, drug prescriptions, indications, and adverse effects.
  
  
  RESULTS
  Psychotropic drugs were prescribed in 45% of cases, most commonly antidepressants (41%), followed by anxiolytics (29%) and antipsychotics (22%), with 8% initiated before referral to the specialist eating disorder program. Common indications were depressed mood, agitation, anxiety, and insomnia. Patient clinical severity and complexity was associated with prescribing. Adverse effects, mostly minor, were recorded in 23% of antidepressant prescriptions, 39% of antipsychotic prescriptions, and 13% of anxiolytic prescriptions. Second generation antipsychotic prescription was associated with subsequent new onset binge eating, in this preliminary observational study. Self-harm by overdose of psychotropics occurred in 11% of patients prescribed medication.
  
  
  CONCLUSIONS
  Psychotropic medications were frequently prescribed to adolescent eating disorder patients to treat distressing symptoms. Prospective randomised controlled trials to clarify efficacy and safety are needed. Given the difficulties of conducting clinical trials in this population, services are encouraged to monitor and audit medication safety and efficacy in everyday practice, and to report their findings.
authors.affiliation: Princess Margaret Hospital for Children, Perth, Australia ; The School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.
authors.forename: Julia K
authors.initials: JK
authors.lastname: Moore
authors.affiliation: Princess Margaret Hospital for Children, Perth, Australia ; Centre for Clinical Interventions, Perth, Australia ; The School of Paediatrics and Child Health, University of Western Australia, Perth, Australia ; The School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
authors.forename: Hunna J
authors.initials: HJ
authors.lastname: Watson
authors.affiliation: Princess Margaret Hospital for Children, Perth, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Harper
authors.affiliation: Princess Margaret Hospital for Children, Perth, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: McCormack
authors.affiliation: The School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.
authors.forename: Thinh
authors.initials: T
authors.lastname: Nguyen
keywords: Adolescent; Adverse effects; Binge eating; Child; Drug therapy; Eating disorders; Pharmacology