Learning Disability Today
Supporting professionals working in learning disability and autism services

‘Concerning’ rise in antipsychotic prescriptions for autistic children

The number of children being prescribed antipsychotics by GPs in England has doubled since 2000, according to a study published in The Lancet Psychiatry.

The study suggests they are prescribed for an increasingly broad range of reasons, but the most common is autism. ADHD, tic disorders and learning difficulties were also common reasons for patients to be prescribed the medication.

The results of the study are based on GP records from 7.2 million children and adolescents. The researchers looked at how many young people were being prescribed antipsychotics, and found the percentage rose from 0.06% in 2000 to 0.11% in 2019.

While the number of young people being prescribed antipsychotics is still relatively small, the researchers from the University of Manchester’s Centre for Women’s Mental Health say the rise is “concerning”.

Antipsychotics can cause significant side effects

Antipsychotics are frequently used in adults to treat major mental illness, such as schizophrenia. However, the National Institute for Clinical Excellence (NICE) only recommends their use in under 18s with psychosis or with severely aggressive behaviour from conduct disorder.

This is because the medication can cause significant side effects such as sexual dysfunction, infertility, and weight gain leading to diabetes.

NICE guidance also states that patients should not “usually be prescribed” antipsychotic medication by a GP (unless they have had advice from a psychiatrist).

“A concerning trend”

The authors of the study say that higher prescribing rates could be due to increasing prevalence of conditions such as autism. However, they note that only a small number of autistic people are likely to be prescribed antipsychotics, and this rapid increase is likely to be caused by GP prescribing habits.

Dr Matthias Pierce, senior research fellow at the University of Manchester’s Centre for Women’s Mental Health, who jointly led the study said: “This study demonstrates a concerning trend in antipsychotic prescribing in children and adolescents.

“We do not think the changes in prescribing necessarily relate to changes in clinical need; rather, it may be more likely to reflect changes in prescribing practice by clinicians.

“However, this study will help clinicians to evaluate the prescribing of antipsychotics to children more fully and will encourage them to consider better access to alternatives,” he concludes.

Further research needed

The researchers are now calling for more research into the use of antipsychotics in children and adolescents, particularly the effect of using the medication over prolonged periods of time.

Senior author, Professor Kathryn Abel from The University of Manchester said: “Antipsychotic medications continue to have a valuable role in the treatment of serious mental illness. These findings represent a descriptive account of antipsychotic prescribing to children and adolescents in the UK today and provide a window onto current practice.

“It is notable, and relevant to the current discourse, that we report inequities in prescribing as a result of deprivation levels; and that the indications for which approvals are available are no longer the commonest reason these medications are being prescribed. Broadening use of antipsychotics in developing young people begs questions about their safety over time and demands more research on this topic.”

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