The use of potent antipsychotic drugs as Abilify and Risperdal to control children with attention deficit disorder with hyperactivity (ADHD) and other behavioral problems has increased considerably in recent years , a new study finds.
Antipsychotic drugs are approved to treat bipolar disorder, schizophrenia, other severe mental problems and irritability associated with autism. But do not have the approval of the Food and Drug Administration (FDA) of USA. States. for ADHD and other pediatric behavioral problems, and its use for this purpose is considered ?off label?.
?Only a small proportion of antipsychotic treatment in children (6 percent) and teens (13 percent) is for clinical indications approved by the FDA,? said lead researcher Dr. Mark Olfson, a professor of clinical psychiatry at the Center Medical University of Columbia in New York City.
?These trends focus national attention on the substantial and growing degree that children diagnosed with ADHD and other disruptive behavior disorders being treated with antipsychotics,? said Olfson.
The researchers found that medical consultations from 1993 to 1998 and from 2005 to 2009 that were related to the prescription of an antipsychotic to a child increased sevenfold, from 0.24 to 1.83 per 100 people. For adolescents aged 14 to 20 years, the rate increased from 0.78 to 3.76 per 100 people, and adults, more or less doubled from 3.25 to 6.18 per 100 people.
Many of the recipes for children were issued by physicians who were not psychiatrists, the researchers found.
Although these drugs can lead to rapid improvement in children with severe behavioral problems and aggressive behavior, it is unclear whether they are useful for the wider group of children with ADHD, raised. Has not been studied long-term effect on the developing brain of children.
Olfson said the majority of children and adolescents treated with antipsychotics did not receive psychotherapy. ?This suggests that more must be done to increase access to and availability of, psychosocial interventions,? he said.
?The parent management training in cognitive skills and problem solving are examples of effective treatments but little used for youth with disruptive behavior problems? he asked.
The study, published in the online edition of the August 6 issue of the Archives of General Psychiatry, used data from national surveys of ambulatory care from 1993 to 2009. In total, included more than 484.000 people.
The researchers found that prescriptions of antipsychotics increased in children and adults. But most doctors prescribed antipsychotics in children and adolescents (68 and 72 percent respectively) than adults (50 percent).
Among children under thirteen years, the most prescribed drug was risperidone (Risperdal). Other medications included aripiprazole (Abilify), quetiapine (Seroquel) and olanzapine (Zyprexa). Of these drugs, Abilify was the most commonly prescribed for adolescents aged 14 to 20 years, the study found.
All those antipsychotic, developed from the 90 are considered ?atypical? or second generation.
For older patients, the FDA recently issued a public health advisory on atypical antipsychotic after determining that death rates are higher among older people with dementia who take them.
Dr. Peter Breggin, a psychiatrist at Ithaca, New York, and an outspoken critic of the widespread use of antipsychotic in children, said that these drugs damage the developing brain.
?We face a national catastrophe,? said Breggin. ?It?s a situation where we have ruined the brains of millions of children.?
To control behavior, antipsychotic act on the brain?s frontal lobes, the same area that addresses a lobotomy, Breggin said.
?These drugs are lobotomized? he added. ?Of course we reduce all behavior, including irritability,? he said.
Olfson?s team found that most children treated with antipsychotic have a diagnosis of ADHD, conduct disorders, oppositional and disruptive behavior unspecified.
Between 2005 and 2009, control of ?disruptive behavior? accounted for 63 percent of the reason for the administration of antipsychotic to children, and nearly 34 percent for adolescents, researchers found.
In contrast, bipolar disorder and depression were the most common reasons for prescribing these drugs to adults in that period.
Simon Rego, director of psychology training at Montefiore Medical Center and Albert Einstein College of Medicine in New York City, warned that these drugs pose serious side effects including weight gain, diabetes and heart problems.
?But perhaps even more important is the finding that a substantial majority of the consultations of children with antipsychotic were youth diagnosed with disruptive behavior disorders for which there is currently no FDA-approved antipsychotic? he asked.
Given the uncertain effects of antipsychotic have on cognitive development (brain), social and physical development of children and adolescents may need to reevaluate the clinical practice patterns, Rego said.
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