title: Treatment of Young People With Antipsychotic Medications in the United States.
abstract: OBJECTIVE
  Despite concerns about rising treatment of young people with antipsychotic medications, little is known about trends and patterns of their use in the United States.
  
  
  OBJECTIVE
  To describe antipsychotic prescription patterns among young people in the United States, focusing on age and sex.
  
  
  METHODS
  A retrospective descriptive analysis of antipsychotic prescriptions among patients aged 1 to 24 years was performed with data from calendar years 2006 (n = 765,829), 2008 (n = 858,216), and 2010 (n = 851,874), including a subset from calendar year 2009 with service claims data (n = 53,896). Data were retrieved from the IMS LifeLink LRx Longitudinal Prescription database, which includes approximately 60% of all retail pharmacies in the United States. Denominators were adjusted to generalize estimates to the US population.
  
  
  METHODS
  The percentage of young people filling 1 or more antipsychotic prescriptions during the study year by sex and age group (younger children, 1-6 years; older children, 7-12 years; adolescents, 13-18 years; and young adults, 19-24 years) was calculated. Among young people with antipsychotic use, percentages with specific clinical psychiatric diagnoses and 1 or more antipsychotic prescriptions from a psychiatrist and from a child and adolescent psychiatrist were also determined.
  
  
  RESULTS
  The percentages of young people using antipsychotics in 2006 and 2010, respectively, were 0.14% and 0.11% for younger children, 0.85% and 0.80% for older children, 1.10% and 1.19% for adolescents, and 0.69% and 0.84% for young adults. In 2010, males were more likely than females to use antipsychotics, especially during childhood and adolescence: 0.16% vs 0.06% for younger children, 1.20% vs 0.44% for older children, 1.42% vs 0.95% for adolescents, and 0.88% vs 0.81% for young adults. Among young people treated with antipsychotics in 2010, receiving a prescription from a psychiatrist was less common among younger children (57.9%) than among other age groups (range, 70.4%-77.9%). Approximately 29.3% of younger children treated with antipsychotics in 2010 received 1 or more antipsychotic prescriptions from a child and adolescent psychiatrist. Among young people with claims for mental disorders in 2009 who were treated with antipsychotics, the most common diagnoses were attention-deficit/hyperactivity disorder in younger children (52.5%), older children (60.1%), and adolescents (34.9%) and depression in young adults (34.5%).
  
  
  CONCLUSIONS
  Antipsychotic use increased from 2006 to 2010 for adolescents and young adults but not for children aged 12 years or younger. Peak antipsychotic use in adolescence, especially among boys, and clinical diagnosis patterns are consistent with management of developmentally limited impulsive and aggressive behaviors rather than psychotic symptoms.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York2Division of Epidemiology, New York State Psychiatric Institute, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
authors.affiliation: School of Management, Yale University, New Haven, Connecticut.
authors.forename: Marissa
authors.initials: M
authors.lastname: King
authors.affiliation: Office of Science Policy, Planning, and Communications, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
authors.forename: Michael
authors.initials: M
authors.lastname: Schoenbaum
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry; D017677:Age Distribution; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000628:therapy; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000628:therapy; D001321:Autistic Disorder / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002665:Child Psychiatry; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D003866:Depressive Disorder / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000453:epidemiology* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011570:Psychiatry; D011613:Psychotherapy / Q000706:statistics & numerical data / Q000639:trends*; D012189:Retrospective Studies; D017678:Sex Distribution; D014481:United States; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents