Experts warn that there is little evidence to support the widespread prescription of mood-altering drugs to children with mental health problems.
In an article published in the medical journal Drug and Therapeutics Bulletin, they say that “psychotropic drugs” have become the “mainstay” of treatment and that doctors are prescribing them to younger patients and for longer periods of time.
But they argue that prescribing practices for these drugs, which include sedatives, anti-anxiety drugs, antidepressants, antipsychotics and melatonin, need to be much safer.
The editorial, written by David Branford, a professor at the University of Plymouth, along with an NHS England adviser and an independent pharmaceutical consultant, suggests the drugs are being overused without proper oversight.
They cite previously published studies in the UK showing that the rate of antipsychotic prescriptions to children rose by more than 3 per cent each year between 2000 and 2019, while the rate of antidepressant prescriptions more than doubled among 12- to 17-year-olds between 2005 and 2017.
In an article published in the medical journal Drug and Therapeutics Bulletin, they say that “psychotropics” have become the “mainstay” of treatment, with doctors prescribing them to younger patients and for longer periods of time (file image)
Another study shows that more than 56,000 children under 17 took melatonin in 2022, representing a 168 percent increase from the equivalent figures in 2015.
Experts stress that the safety of psychotropic drugs in children has not been fully studied.
But they note that safety concerns about prescribing antipsychotics to children in foster care in particular have led the American Academy of Child and Adolescent Psychiatry to issue guidelines for doctors, advocating a “start low and work up slowly” approach.
The authors say drugs need to be reviewed regularly and discontinued as soon as possible, but evidence suggests primary care physicians do not feel confident enough to reduce dosage and frequency, while hospital doctors feel inpatient stays are not long enough for this to be initiated, they add.
“If prescribing psychotropic drugs is to become a mainstay of treatment for childhood mental health problems, and there is a limited evidence base supporting such use, it must be made safer,” the experts write.
‘There is a need to better understand the level of risk posed by psychotropic drugs, what doses are considered safe in different age groups, and at what point physical health monitoring should become mandatory.’
They conclude: “Better coordinated supervision and shared decision-making, involving young people and their families in discussions about medication in both primary and secondary care, is vital to ensure that treatments are not continued when they are no longer needed.”