There is little evidence to support the widespread prescribing of mood-altering drugs to children for mental health issues, experts warn.
Writing in medical journal Drug and Therapeutics Bulletin, they say ‘psychotropics’ have become the ‘mainstay’ of treatment, with doctors issuing them to more young patients and for longer.
But they argue prescribing practices for these drugs, which include sedatives, anti-anxiolytics, antidepressants, antipsychotics, and melatonin, must be made a lot safer.
The editorial – written by David Branford, a professor at Plymouth University, alongside an NHS England advisor and independent pharmacy consultant – suggests the drugs are being overused without proper oversight.
They cite previously published UK studies, showing that the prescribing rate of antipsychotics for children rose more than 3 per cent every year between 2000 and 2019, while the prescribing rate of antidepressants more than doubled among 12 to 17 year olds between 2005 and 2017.
Writing in medical journal Drug and Therapeutics Bulletin, they say ‘psychotropics’ have become the ‘mainstay’ of treatment, with doctors issuing them to more young patients and for longer (stock image)
Another study shows that more than 56,000 under-17s were taking melatonin in 2022, which represents an increase of 168 per cent on the equivalent figures for 2015.
The safety of psychotropic use in children is poorly researched, the experts stress.
But they highlight safety concerns about antipsychotic prescribing to children in foster care in particular have prompted the American Academy of Child and Adolescent Psychiatry to issue guidelines for clinicians, advocating a ‘start low, go slow’ approach.
The authors say the drugs need to be regularly reviewed and discontinued at the earliest opportunity but the evidence suggests that clinicians in primary care do not feel confident enough to taper the dose and frequency, while hospital doctors feel that inpatient stays are not long enough for this to be started, they add.
‘If psychotropic prescribing is to become a mainstay of the management of childhood mental health problems, and there is a limited evidence base to support such use, it needs to be safer,’ the experts write.
‘There is a need to better understand the level of risk that psychotropics pose, what doses are considered safe in different age groups, and at what point physical health monitoring should become mandatory.’
They conclude: ‘Better joined-up oversight and shared decision-making, involving young people and their families in discussions about medication both in primary and secondary care, to ensure that treatments are not continued when no longer required, is vital.’
