Harvard Mental Health Letter

Understanding the risks of antipsychotic treatment in young people

Advice for managing side effects in children and teenagers.

Antipsychotic prescriptions for children and teenagers have increased dramatically since the late 1990s, although the FDA has approved only three such drugs for use in young people: haloperidol (Haldol), thioridazine (Mellaril), and risperidone (Risperdal). An analysis of data from the Medical Expenditure Panel Survey, an annual compilation of information about health care services used by 23,000 to 35,000 Americans, found that the number of children and teenagers taking antipsychotics more than tripled between 1997 and 2005, increasing from 0.2% to 0.7% of all youths. Other studies have reported similar increases.

A variety of factors have contributed to this trend, including aggressive marketing by pharmaceutical companies and lack of reimbursement for psychotherapy and other nondrug treatments by insurance companies. Pressed for time, clinicians may be tempted to prescribe antipsychotics based on a one-session evaluation of a patient's symptoms, but a more thorough diagnostic evaluation might suggest other treatments more in tune with the child's needs.

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