Prescribing patterns in adolescent psychiatric practice: an important role of antipsychotics

Many adolescents affected by psychiatric disorders require pharmacological treatment. Knowing which medication is being used is of utmost importance. Our main objective was to gain insight into prescribing patterns at the Department of child and adolescent psychiatry, Clinical Hospital Centre Rijeka. In addition, we looked for potential differences between adolescents regarding their pharmacotherapy status.

The data from medical charts of 227 adolescents (55% females), age 12-18 years (16.4±1.18) were analysed. All of them were treated as outpatients during one year period (2014/15). Medical charts were obtained from the computerized archive system of Clinical Hospital Centre. Prescribed drug patterns were taken into account if patients have been taking medication for at least one month.

Most of the patients, 162 (71.4%), were treated with psychiatric medication. In the pharmacologically treated group, adolescents were older (t=-4.678; p<0.001), predominately male (χ²=5.175, p=0.023) and hospitalized (χ²=20.612, p<0.0001). Accordingly, male (OR=2.09, P<0.05) and hospitalized (OR=15.32, P<0.001) adolescents were more disposed to be medicated. Psychotic disorder was the most commonly diagnosed disorder (51 patients). There were 454 different prescribing patterns, mostly prescribed antipsychotics, 36.6% of all prescriptions; followed by 31.5% anxiolytics' and 23.7% antidepressants' prescriptions. However, number of patients receiving antipsychotics, anxiolytics and antidepressants was quite similar (103: 110: 99). The highest number of patients was treated with sertraline (58), followed by those treated with risperidone (48). Majority of the patients (104/227) were treated with polytherapy.

Prescribing psychiatric pharmacotherapy for adolescents is a common clinical practice. Adolescents that were prescribed pharmacotherapy were significantly older; hospitalized and male adolescents were more prone to be medicated. Antipsychotics were most frequently prescribed drugs. The prescribing patterns are generally consistent with international trends and guidelines; however caution regarding high proportion of polytherapy is necessary.