Patterns of Antipsychotic Prescribing by Physicians to Young Children

Area of Science:

• Child and Adolescent Psychiatry
• Pharmacology
• Public Health

Background:

• Antipsychotic medication use in young children has increased significantly.
• This use often occurs despite a lack of U.S. Food and Drug Administration (FDA) approval for this age group.
• Understanding physician prescribing patterns is crucial for patient safety and appropriate treatment.

Purpose of the Study:

• To identify characteristics of physicians prescribing antipsychotics to young children (ages 0-9).
• To compare antipsychotic prescribing patterns in young children versus adults (ages 20-64).
• To examine the FDA-approved indication status of prescribed antipsychotics for different age groups.

Main Methods:

• Utilized physician-level prescribing data from IMS Health's Xponent database (2008-2011).
• Linked prescribing data with American Medical Association Masterfile data for U.S. psychiatrists and a sample of family medicine physicians.
• Employed logistic and hierarchical binomial regression models to analyze prescribing behaviors and compare medication types and quantities.

Main Results:

• Over 42% of antipsychotic prescribers had prescribed to young children.
• Younger physicians (≤39) and those in rural areas were more likely to prescribe to children.
• Prescriptions for children were less likely to have an FDA-approved indication compared to adults, and fewer antipsychotic agents were used.
• Male physicians and graduates of top-ranked medical schools were less likely to prescribe to children.

Conclusions:

• Antipsychotic prescribing for young children is a relatively common practice.
• Significant differences exist in prescribing patterns between young children and adult populations.
• Further research is needed to understand the implications of off-label antipsychotic use in pediatric populations.