Researchers have discovered that children diagnosed with autism or intellectual difficulty are more likely to be antipsychotic medication than their peers. Professor Sinead Brophy and her colleagues at Swansea University investigated how antipsychotics are used in the NHS. As part of the cohort study they connected hospital, GP and educational records for 3028 young people who had been prescribed an antipsychotic (via Science Daily).
The study’s key findings:
children with intellectual difficulty or autism were more likely to be given an antipsychotic. The study found:
- 2.8% had been prescribed antipsychotics
- 75% of these children had autism
- This compares with 0.15% of those without intellectual disability.
Objective: Antipsychotics are licensed for psychosis and are also prescribed for behavior control. This study aims to examine characteristics and outcomes of children prescribed antipsychotics.
Methods: A cohort study using general practice and hospital records linked with education records for 1,488,936 children living in Wales between 1999 and 2015. The characteristics of the children who were prescribed antipsychotics are presented using descriptive statistics and outcomes such as respiratory illness, diabetes, and injury were analyzed using multilevel logistic regression and the prior event rate ratio (PERR).
Results: Children with intellectual difficulty/autism were more likely to be prescribed antipsychotics (2.8% have been prescribed an antipsychotic [75% with autism] compared with 0.15% of children without intellectual difficulty). Those with intellectual disabilities/autism were prescribed antipsychotics at a younger age and for a longer period. Antipsychotic use was associated with a higher rate of respiratory illness for all (PERR of hospital admission: 1.55 [95% CI: 1.51–1.598] or increase in rate of 2 per 100 per year in those treated), and for those with intellectual difficulty/autism, there was a higher rate of injury and hospitalized depression. However, among those without intellectual difficulty/autism, there were lower rates of depression (PERR: 0.55 [95% CI: 0.51–0.59]).
Conclusions: This work shows real-world use of antipsychotics and provides information on the rate of possible adverse events in children treated. Antipsychotics are predominantly used for those with intellectual difficulty/autism rather than those with a psychotic diagnosis. There is evidence that rates of respiratory disease, epilepsy, and diabetes are also higher post antipsychotic use for all. In those with intellectual difficulty/autism, hospital-admitted depression and injury are higher post antipsychotic use. The use of antipsychotics for behavioral management is likely to have increased cost implications to the healthcare system.
Brophy, S., et al |April 2018 | Characteristics of Children Prescribed Antipsychotics: Analysis of Routinely Collected Data | Journal of Child and Adolescent Psychopharmacology | Doi: 10.1089/cap.2017.0003
The full journal article can be read at the Journal of Child and Adolescent Psychopharmacology here