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Rise in Psychotropic Drug Prescribing in Children and Adolescents during 1992-2001: A Population-Based Study in the Uk

Background The trend towards increased psychotropic drug prescribing in children and adolescents is well recognised in North America and continental Europe. However, it is unclear to what extent these studies are applicable to clinical practice in the United Kingdom (UK). This study was conducted to...

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Published in:European journal of epidemiology 2009-04, Vol.24 (4), p.211-216
Main Authors: Hsia, Yingfen, Maclennan, Karyn
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description Background The trend towards increased psychotropic drug prescribing in children and adolescents is well recognised in North America and continental Europe. However, it is unclear to what extent these studies are applicable to clinical practice in the United Kingdom (UK). This study was conducted to estimate the prevalence of psychotropic drug prescribing in children and adolescents aged < 19 years in general practice in the UK from January 1992 to December 2001. Methods Data were obtained from the General Practice Research Database (GPRD). Annual age-and sex-specific prevalence of psychotropic drug prescribing was calculated. Results A total of 143,079 prescriptions were issued to 34,398 study subjects. Stimulant prescriptions rose significantly from 0.03 per 1,000 (95% confidence interval 0.02-0.04) in 1992 to 2.9 per 1,000 (2.52-3.32) in 2001; a 96-fold increase. Methylphenidate accounted for the majority of stimulant prescriptions; 2.4% (349/ 14,370) of stimulant prescriptions were prescribed to children aged < 6 years. Increased prescribing was also noted for antidepressants (1.6-fold), hypnotics/anxiolytics (1.3-fold), antipsychotics (1.3-fold) and anticonvulsants (1.3-fold), whilst the prevalence of clonidine and lithium prescribing remained fairly stable throughout the study period. The use of antidepressant, hypnotic/ anxiolytic and anticonvulsant increased with increasing age. A high proportion of boys received stimulants, whereas antidepressants and hypnotics/anxiolytics were more likely prescribed to girls. Conclusion There is an increased trend of psychotropic drug use in children and adolescents in the UK practice. Since most psychotropic drugs are not licensed for use in children at this time, research is needed to investigate the efficacy and long-term safety in this population.
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However, it is unclear to what extent these studies are applicable to clinical practice in the United Kingdom (UK). This study was conducted to estimate the prevalence of psychotropic drug prescribing in children and adolescents aged &lt; 19 years in general practice in the UK from January 1992 to December 2001. Methods Data were obtained from the General Practice Research Database (GPRD). Annual age-and sex-specific prevalence of psychotropic drug prescribing was calculated. Results A total of 143,079 prescriptions were issued to 34,398 study subjects. Stimulant prescriptions rose significantly from 0.03 per 1,000 (95% confidence interval 0.02-0.04) in 1992 to 2.9 per 1,000 (2.52-3.32) in 2001; a 96-fold increase. Methylphenidate accounted for the majority of stimulant prescriptions; 2.4% (349/ 14,370) of stimulant prescriptions were prescribed to children aged &lt; 6 years. Increased prescribing was also noted for antidepressants (1.6-fold), hypnotics/anxiolytics (1.3-fold), antipsychotics (1.3-fold) and anticonvulsants (1.3-fold), whilst the prevalence of clonidine and lithium prescribing remained fairly stable throughout the study period. The use of antidepressant, hypnotic/ anxiolytic and anticonvulsant increased with increasing age. A high proportion of boys received stimulants, whereas antidepressants and hypnotics/anxiolytics were more likely prescribed to girls. Conclusion There is an increased trend of psychotropic drug use in children and adolescents in the UK practice. Since most psychotropic drugs are not licensed for use in children at this time, research is needed to investigate the efficacy and long-term safety in this population.</description><identifier>ISSN: 0393-2990</identifier><identifier>EISSN: 1573-7284</identifier><identifier>DOI: 10.1007/s10654-009-9321-3</identifier><identifier>PMID: 19266290</identifier><identifier>CODEN: EJEPE8</identifier><language>eng</language><publisher>Dordrecht: Springer</publisher><subject>Adolescent ; Adolescents ; Age Distribution ; Antidepressants ; Antipsychotic agents ; Antipsychotics ; Biological and medical sciences ; Cardiology ; Child ; Child, Preschool ; Childhood mental disorders ; Children ; Confidence Intervals ; Drug Prescriptions - statistics &amp; numerical data ; Drug use ; Drug Utilization - trends ; Epidemiology ; Female ; General aspects ; General practice ; Humans ; Infectious Diseases ; Lithium ; Male ; Medical sciences ; Medications ; Medicine ; Medicine &amp; Public Health ; Mental disorders ; Miscellaneous ; Oncology ; Pediatrics ; Pharma Co-Epidemiology ; Pharmaco-Epidemiology ; Population studies ; Practice Patterns, Physicians' - statistics &amp; numerical data ; Practice Patterns, Physicians' - trends ; Prevalence ; Psychotropic drugs ; Psychotropic Drugs - classification ; Psychotropic Drugs - therapeutic use ; Psychotropics ; Public Health ; Public health. 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Hygiene-occupational medicine ; Retrospective Studies ; Sex Distribution ; Stimulants ; United Kingdom</subject><ispartof>European journal of epidemiology, 2009-04, Vol.24 (4), p.211-216</ispartof><rights>Copyright 2009 Springer</rights><rights>Springer Science+Business Media B.V. 2009</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518t-5b23fff7c7c6de8c2b9fe9c0675561e9174c12ac2e653b3072b9b8fb791c5dc3</citedby><cites>FETCH-LOGICAL-c518t-5b23fff7c7c6de8c2b9fe9c0675561e9174c12ac2e653b3072b9b8fb791c5dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/40284112$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/40284112$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,58213,58446</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=21338342$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19266290$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hsia, Yingfen</creatorcontrib><creatorcontrib>Maclennan, Karyn</creatorcontrib><title>Rise in Psychotropic Drug Prescribing in Children and Adolescents during 1992-2001: A Population-Based Study in the Uk</title><title>European journal of epidemiology</title><addtitle>Eur J Epidemiol</addtitle><addtitle>Eur J Epidemiol</addtitle><description>Background The trend towards increased psychotropic drug prescribing in children and adolescents is well recognised in North America and continental Europe. However, it is unclear to what extent these studies are applicable to clinical practice in the United Kingdom (UK). This study was conducted to estimate the prevalence of psychotropic drug prescribing in children and adolescents aged &lt; 19 years in general practice in the UK from January 1992 to December 2001. Methods Data were obtained from the General Practice Research Database (GPRD). Annual age-and sex-specific prevalence of psychotropic drug prescribing was calculated. Results A total of 143,079 prescriptions were issued to 34,398 study subjects. Stimulant prescriptions rose significantly from 0.03 per 1,000 (95% confidence interval 0.02-0.04) in 1992 to 2.9 per 1,000 (2.52-3.32) in 2001; a 96-fold increase. Methylphenidate accounted for the majority of stimulant prescriptions; 2.4% (349/ 14,370) of stimulant prescriptions were prescribed to children aged &lt; 6 years. Increased prescribing was also noted for antidepressants (1.6-fold), hypnotics/anxiolytics (1.3-fold), antipsychotics (1.3-fold) and anticonvulsants (1.3-fold), whilst the prevalence of clonidine and lithium prescribing remained fairly stable throughout the study period. The use of antidepressant, hypnotic/ anxiolytic and anticonvulsant increased with increasing age. A high proportion of boys received stimulants, whereas antidepressants and hypnotics/anxiolytics were more likely prescribed to girls. Conclusion There is an increased trend of psychotropic drug use in children and adolescents in the UK practice. Since most psychotropic drugs are not licensed for use in children at this time, research is needed to investigate the efficacy and long-term safety in this population.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Age Distribution</subject><subject>Antidepressants</subject><subject>Antipsychotic agents</subject><subject>Antipsychotics</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Childhood mental disorders</subject><subject>Children</subject><subject>Confidence Intervals</subject><subject>Drug Prescriptions - statistics &amp; numerical data</subject><subject>Drug use</subject><subject>Drug Utilization - trends</subject><subject>Epidemiology</subject><subject>Female</subject><subject>General aspects</subject><subject>General practice</subject><subject>Humans</subject><subject>Infectious Diseases</subject><subject>Lithium</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medications</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Mental disorders</subject><subject>Miscellaneous</subject><subject>Oncology</subject><subject>Pediatrics</subject><subject>Pharma Co-Epidemiology</subject><subject>Pharmaco-Epidemiology</subject><subject>Population studies</subject><subject>Practice Patterns, Physicians' - statistics &amp; numerical data</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Prevalence</subject><subject>Psychotropic drugs</subject><subject>Psychotropic Drugs - classification</subject><subject>Psychotropic Drugs - therapeutic use</subject><subject>Psychotropics</subject><subject>Public Health</subject><subject>Public health. 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However, it is unclear to what extent these studies are applicable to clinical practice in the United Kingdom (UK). This study was conducted to estimate the prevalence of psychotropic drug prescribing in children and adolescents aged &lt; 19 years in general practice in the UK from January 1992 to December 2001. Methods Data were obtained from the General Practice Research Database (GPRD). Annual age-and sex-specific prevalence of psychotropic drug prescribing was calculated. Results A total of 143,079 prescriptions were issued to 34,398 study subjects. Stimulant prescriptions rose significantly from 0.03 per 1,000 (95% confidence interval 0.02-0.04) in 1992 to 2.9 per 1,000 (2.52-3.32) in 2001; a 96-fold increase. Methylphenidate accounted for the majority of stimulant prescriptions; 2.4% (349/ 14,370) of stimulant prescriptions were prescribed to children aged &lt; 6 years. Increased prescribing was also noted for antidepressants (1.6-fold), hypnotics/anxiolytics (1.3-fold), antipsychotics (1.3-fold) and anticonvulsants (1.3-fold), whilst the prevalence of clonidine and lithium prescribing remained fairly stable throughout the study period. The use of antidepressant, hypnotic/ anxiolytic and anticonvulsant increased with increasing age. A high proportion of boys received stimulants, whereas antidepressants and hypnotics/anxiolytics were more likely prescribed to girls. Conclusion There is an increased trend of psychotropic drug use in children and adolescents in the UK practice. Since most psychotropic drugs are not licensed for use in children at this time, research is needed to investigate the efficacy and long-term safety in this population.</abstract><cop>Dordrecht</cop><pub>Springer</pub><pmid>19266290</pmid><doi>10.1007/s10654-009-9321-3</doi><tpages>6</tpages></addata></record>
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subjects Adolescent
Adolescents
Age Distribution
Antidepressants
Antipsychotic agents
Antipsychotics
Biological and medical sciences
Cardiology
Child
Child, Preschool
Childhood mental disorders
Children
Confidence Intervals
Drug Prescriptions - statistics & numerical data
Drug use
Drug Utilization - trends
Epidemiology
Female
General aspects
General practice
Humans
Infectious Diseases
Lithium
Male
Medical sciences
Medications
Medicine
Medicine & Public Health
Mental disorders
Miscellaneous
Oncology
Pediatrics
Pharma Co-Epidemiology
Pharmaco-Epidemiology
Population studies
Practice Patterns, Physicians' - statistics & numerical data
Practice Patterns, Physicians' - trends
Prevalence
Psychotropic drugs
Psychotropic Drugs - classification
Psychotropic Drugs - therapeutic use
Psychotropics
Public Health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Retrospective Studies
Sex Distribution
Stimulants
United Kingdom
title Rise in Psychotropic Drug Prescribing in Children and Adolescents during 1992-2001: A Population-Based Study in the Uk
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