title: Antipsychotic use in children and adolescents: a 1-year follow-up study.
abstract: OBJECTIVE
  The objective of this study was to analyze the initial treatment with antipsychotics (APs) and its changes during the first year of treatment in patients visited in specialized child and adolescent psychiatry departments.
  
  
  METHODS
  Participants were 265 patients, aged 4 to 17 years, who attended consecutively at 4 different centers and were naive of AP or quasi-naive (less than 30 days since the beginning of AP treatment). Type of AP, dosage, and concomitant medication were registered at baseline, 1, 3, 6, and 12 months after beginning the treatment with AP.
  
  
  RESULTS
  At baseline, the patients' mean age was 14.4 (2.9) years, and 145 (54.7%) patients were males. Antipsychotics were more prescribed in the following: schizophrenia spectrum disorders (30.2%), disruptive behavior disorders (DBDs) (18.9%), bipolar disorders (14.3%), depressive disorders (12.8%), and eating disorders (11.7%). A total of 93.2% of the patients were on an off-label indication of AP. Risperidone was the AP most prescribed in all the assessments, but differences were observed in the type of AP according to diagnosis. Thus, risperidone was significantly most prescribed in patients with DBD and olanzapine was most prescribed in patients with eating disorders. Olanzapine and quetiapine were the second-generation APs (SGAs) most prescribed after risperidone, and haloperidol was the most prescribed first-generation AP. Up to 8.3% of patients during the follow-up were on AP polypharmacy. Almost 16% patients had a change in its AP treatment during the follow-up, and the main switch was from one SGA to another.
  
  
  CONCLUSIONS
  Second-generation APs were the APs most prescribed in our sample and approximately 93% of the patients used AP off-label. Risperidone was the most common AP used above all in patients with DBD, whereas olanzapine was most prescribed in patients with eating disorders. Antipsychotic polypharmacy and switch rates were low during the follow-up.
authors.affiliation: From the *Department of Child and Adolescent Psychiatry and Psychology, Institute Clinic of Neurosciences, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic Universitari of Barcelona, Barcelona; †Department of Psychiatry and Psychobiology, Health Sciences Division, University of Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ‡Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, School of Medicine, Universidad Complutense, CIBERSAM; §Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús; and ∥Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, CIBERSAM, Madrid, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Baeza
authors.forename: Elena
authors.initials: E
authors.lastname: de la Serna
authors.forename: Rosa
authors.initials: R
authors.lastname: Calvo-Escalona
authors.forename: Astrid
authors.initials: A
authors.lastname: Morer
authors.forename: Jessica
authors.initials: J
authors.lastname: Merchán-Naranjo
authors.forename: Cecilia
authors.initials: C
authors.lastname: Tapia
authors.forename: Ma Carmen
authors.initials: MC
authors.lastname: Martínez-Cantarero
authors.forename: Patrícia
authors.initials: P
authors.lastname: Andrés
authors.forename: José A
authors.initials: JA
authors.lastname: Alda
authors.forename: Bernardo
authors.initials: B
authors.lastname: Sánchez
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013030:Spain
chemical_list: D014150:Antipsychotic Agents