Sanne M Kloosterboer1, Catharina C M Schuiling-Veninga2, Jens H J Bos2, Luuk J Kalverdijk3, Birgit C P Koch1, Gwen C Dieleman4, Manon H J Hillegers4, Bram Dierckx4. 1. Department of Hospital Pharmacy, Erasmus Medical Centre, Rotterdam, The Netherlands. 2. Department of Pharmacotherapy, -Epidemiology and -Economics, University of Groningen, Groningen, The Netherlands. 3. Department of Psychiatry, University of Groningen, University Medical Centre Groningen, The Netherlands. 4. Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Abstract
Objectives: The use of antipsychotic drugs by youth is associated with serious side effects, especially when prescribed in higher dosages and for a longer period. Despite this, little is known about recent trends in the dosages and duration of use of antipsychotic drugs in children and adolescents. The aim of this study was to describe trends in prevalence, incidence, dosages, duration of use, and preceding psychotropic medication in Dutch youth who had been prescribed antipsychotic drugs from 2005 to 2015. Methods: We analyzed 84,828 antipsychotic prescriptions of youths aged 0-19 years between 2005 and 2015, derived from a large Dutch community pharmacy-based prescription database (IADB.nl). Results: Since a peak of 9.8 users per 1000 youths in 2009, prevalence rates stabilized. Dosages in milligram per kilogram declined for the most frequently prescribed antipsychotic drugs during the study period. The median duration of use was 6.0 (95% CI 5.4-6.6) months. Boys used antipsychotic drugs significantly longer than girls, with a median of 6.9 (95% CI 6.1-7.7) versus 4.6 (95% CI 3.9-5.3) months (p < 0.01). Of the youths prescribed antipsychotics, 12.4% used them for at least 48 months. The majority of youths had used other psychotropic agents in the year before the start of an antipsychotic drug (62.4% in 2005 and 64.7% in 2015). Conclusions: Despite a stabilization of usage rates and decline in dosages and duration of use, one in eight youths still used antipsychotic drugs for 4 years or longer. A substantial share of youths may, therefore, be at high risk for serious side effects.
Objectives: The use of antipsychotic drugs by youth is associated with serious side effects, especially when prescribed in higher dosages and for a longer period. Despite this, little is known about recent trends in the dosages and duration of use of antipsychotic drugs in children and adolescents. The aim of this study was to describe trends in prevalence, incidence, dosages, duration of use, and preceding psychotropic medication in Dutch youth who had been prescribed antipsychotic drugs from 2005 to 2015. Methods: We analyzed 84,828 antipsychotic prescriptions of youths aged 0-19 years between 2005 and 2015, derived from a large Dutch community pharmacy-based prescription database (IADB.nl). Results: Since a peak of 9.8 users per 1000 youths in 2009, prevalence rates stabilized. Dosages in milligram per kilogram declined for the most frequently prescribed antipsychotic drugs during the study period. The median duration of use was 6.0 (95% CI 5.4-6.6) months. Boys used antipsychotic drugs significantly longer than girls, with a median of 6.9 (95% CI 6.1-7.7) versus 4.6 (95% CI 3.9-5.3) months (p < 0.01). Of the youths prescribed antipsychotics, 12.4% used them for at least 48 months. The majority of youths had used other psychotropic agents in the year before the start of an antipsychotic drug (62.4% in 2005 and 64.7% in 2015). Conclusions: Despite a stabilization of usage rates and decline in dosages and duration of use, one in eight youths still used antipsychotic drugs for 4 years or longer. A substantial share of youths may, therefore, be at high risk for serious side effects.
Entities:
Keywords:
antipsychotics; dosages; duration of use; incidence; prevalence; psychopharmacoepidemiology
Authors: Sanne M Kloosterboer; Karin M Egberts; Brenda C M de Winter; Teun van Gelder; Manfred Gerlach; Manon H J Hillegers; Gwen C Dieleman; Soma Bahmany; Catrien G Reichart; Emma van Daalen; Mirjam E J Kouijzer; Bram Dierckx; Birgit C P Koch Journal: Clin Pharmacokinet Date: 2020-11 Impact factor: 6.447
Authors: Sanne Maartje Kloosterboer; Brenda C M de Winter; Catrien G Reichart; Mirjam E J Kouijzer; Matthias M J de Kroon; Emma van Daalen; Wietske A Ester; Rob Rieken; Gwen C Dieleman; Daphne van Altena; Beatrijs Bartelds; Ron H N van Schaik; Kazem Nasserinejad; Manon H J Hillegers; Teun van Gelder; Bram Dierckx; Birgit C P Koch Journal: Br J Clin Pharmacol Date: 2020-07-26 Impact factor: 3.716