Trends in Atypical Antipsychotic Use Among Children and Adolescents With Depressive Disorders in Korea

Atypical antipsychotics (AAPs) are increasingly prescribed to children and adolescents. Most AAPs are prescribed off-label for children and adolescents with depressive disorders. We investigated the longitudinal trends and patterns of AAP prescription in Korean children and adolescents with depressive disorders.

We conducted a population-based study using data from the Korean National Health Insurance Review and Assessment Service to assess AAP prescriptions among Koreans aged 0-18 years with depressive disorders between 2010 and 2022. An annual cross-sectional assessment was used to analyze longitudinal trends. Additionally, we focused on the most recent year (2022) to assess the current prescription patterns of AAP.

The annual proportion of AAP prescriptions among children and adolescents with depressive disorders will increase from 10.4% in 2010 to 40.0% in 2022 (average annual percentage change: 14.9; 95% confidence interval, 14.3 to 16.3). This trend was more pronounced in patients with depressive disorders with psychiatric comorbidities than in those without psychiatric comorbidities. Over the last 13 years, the predominantly prescribed AAPs have shifted from risperidone to aripiprazole. According to recent data (2022), the most-prescribed AAP for children and adolescents with depressive disorders was aripiprazole, followed by risperidone, quetiapine, and olanzapine. Children and adolescents with depressive disorders and psychiatric comorbidities, particularly Attention-Deficit Hyperactivity Disorder, were more frequently prescribed AAPs (P < 0.001).

The use of AAPs has progressively increased among Korean children and adolescents with depressive disorders, particularly among those with psychiatric comorbidities. Further studies are needed to establish safer and more evidence-based AAP treatments for depressive disorders in children and adolescents.