AJANKOHTAISTA


09.06.2020

Antipsychotic use has increased, particularly among girls

The use of antipsychotics among children and adolescents has doubled in 10 years. The share of girls has been rapidly growing.

In ten years, the number of first-time buyers of antipsychotics for children and adolescents under the age of 18 has almost doubled in Finland. The biggest increase in the number of first-time purchasers has occurred among 13–17-year-olds, and the increase has been more rapid among girls than boys within the two most recent years of monitoring.

The year 2011 was the turning point when the share of girls as first-time buyers of antipsychotics exceeded the share of boys. In the same year, quetiapine surpassed risperidone as the most commonly used antipsychotic among first-time buyers.

“Quetiapine is used for a short-term treatment of conditions such as anxiety and insomnia when necessary, whereas risperidone is used for longer periods to treat issues such as aggressions related to autistic spectrum disorder and severe behavioural problems”, says Eveliina Varimo, a physician specialising in pediatric psychiatry.

Varimo studied the incidence of new antipsychotic users among children and adolescents in Finland. Incidence shows the number of cases detected in a certain population over a certain period of time. The study is the first article published as part of Varimo’s doctoral dissertation, and it was recently published in the Frontiers in Psychiatry journal.

The study is based on the medicinal product purchase and disability allowance registers of the Social Insurance Institution of Finland covering the period 2008–2017. During the period, 70,000 purchases of antipsychotics were made for 1–17-year-olds. Of this population, the study included 26,353 children and adolescents who started using the drug for the first time.

Antipsychotics necessary as part of other treatment

In children and adolescents, the official indications for antipsychotics include the short-term treatment of aggression related to behavioural disorders in those over 5 years of age with a mental disability, and the treatment of psychoses and bipolar disorder.

However, antipsychotics are primarily used to treat behavioural disorders, anxiety and insomnia. While there is relatively little research evidence on the use of antipsychotics in treating these disorders, related clinical experience has been collected.

“Children and young people come to the emergency clinic for reasons such as aggression, anxiety or insomnia. Antipsychotics can provide help in such situations as part of other psychiatric treatment”, says Eveliina Varimo.

In addition to their benefits, antipsychotics have significant adverse effects, such as weight gain, metabolic adverse effects and daytime drowsiness.

“The duration of medication and the relationship between benefits and adverse effects must be monitored. You must also always make sure that the drugs are only one part of the child’s or adolescent’s care”, Varimo emphasises.

Of the first-time buyers of antipsychotics, 32% have been granted disability allowance, which indicates that these persons have a more severe psychiatric disorder or illness.

In the next articles related to her doctoral study, Varimo will examine the duration of antipsychotic use and the factors affecting this based on the same data set. A questionnaire survey will also be used to investigate parents’ attitudes and beliefs concerning psychotropic medication for children.

The supervisors of this study were Eeva Aronen, Professor of Pediatric Psychiatry, University of Helsinki, Head Physician, HUS Child Psychiatry; and Leena Saastamoinen, Research Manager, Docent, Social Insurance Institution of Finland.

Contact details
Eveliina Varimo
eveliina.varimo@helsinki.fi
+358 40 7587111

Link to article
https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00316/full

The scientific community of the Pediatric Research Center of the Helsinki University Hospital produces nearly 300 peer-reviewed articles and a dozen dissertations annually. The scientific community consists of over 30 research groups from all fields of pediatric medicine. The researchers annually receive over 70 research permits. www.lastentautientutkimuskeskus.fi