Antipsychotic Use In Children Drops
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IMAGE SOURCE: © Wikimedia Commons / Risperdal / author: Housed
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When Florida began requiring physicians to obtain approval from the state before prescribing antipsychotics to children under the age of six, something dramatic happened - prescriptions dropped 75 percent, according to statistics from the state Agency for Health Care Administration.
The St. Petersburg Times reports the data was taken from the Florida Medicaid program and finds nearly 40 percent fewer physicians wrote prescriptions for the drugs including Risperdal (Ortho McNeil Janssen), Abilify (Otsuka), Seroquel (AstraZeneca), and Zyprexa (Eli Lilly).
The number of pediatric prescriptions dropped to 1,137 from 3,167 from a year earlier after Florida hired psychiatric consultants to review the prescription as a condition of Medicaid coverage. The state still reportedly approves three out of every four prescriptions of antipsychotics for children, primarily refills.
Risperdal was the most commonly prescribed and among preschoolers, half of the children had autism or developmental disorder who had received prior authorization for the drugs in 2008.
Florida began requiring prior approval in April 2008 after intense debate over the use of antipsychotics in children, reports the St. Petersburg Times.
Nationwide Trend
Nationally there appears to be a softening in sales for children’s antipsychotic-drug prescriptions.
The Wall Street Journal, quoting SDI, which tracks pharmaceutical sales, reports all antipsychotics sold to the under 18 group, account for 15 percent of sales. Sales of Risperidone (Risperdal) to those under 18 account for about one-quarter of sales
Another group, Medco Health Solutions, reports that sales fell four percent last year for antipsychotics for use under ten.
The WSJ reports the numbers dropped from 8.73 percent between 2007 to 2007, to 5.2 percent between 2007 and 2008, all down from a high of about 12 percent in sales in 2003.
Atypicals were introduced in the 1990s and thought to be safer to treat adult schizophrenia and bipolar disorder. They were increasingly used off-label to treat insomnia to dementia. Pediatric prescription use followed to calm disruptive or irritable children or children with autism as well as bipolar disorder, despite side effects of weight gain and diabetes.
Stories of conflict-of-interest between drug makers and academics, who write prescriptions and author professional journals, have been uncovered by Sen. Charles Grassley over the last year. A particular focus has been the pediatric use of atypicals.
Last year it was revealed that a leading proponent of the use of Risperdal in kids, Harvard's Dr. Joseph Biederman, received more than $1.6 million from Johnson & Johnson, maker of the drug. Johnson & Johnson also helped the doctor fund a research center to “move forward the commercial goals of J&J." #