The Decline of Child Antipsychotic Medications


Antipsychotic medications for young children are not being prescribed appropriately, according to a recent study.


According to a Rutgers study1, despite significant decline in antipsychotic use in privately insured children since 2009, doctors continue to prescribe antipsychotic medication off-label for conditions not approved by the US Food and Drug Administration. These conditions include conduct disorder, attention-deficit/hyperactivity disorder, anxiety, and depression.

“We lack information on the effectiveness and safety of antipsychotics for treating those conditions in young children,” lead author Greta Bushnell, PhD, MSPH, a member of the Rutgers Institute for Health, Health Care Policy and Aging Research and an assistant professor at Rutgers School of Public Health, said to the press. “Guidelines recommend that psychosocial services are used before antipsychotic treatment and that children are carefully assessed before initiating antipsychotics. However, fewer than half of the children receiving antipsychotic treatment in our study had a visit with a psychiatrist or a psychotherapy claim.”2

Published in the Journal of the American Academy of Child & Adolescent Psychiatry, the study examined more than 300,00 antipsychotic prescriptions for privately insured children in the United States aged 2 to 7. The study also found antipsychotics were more often prescribed to boys aged 6 or 7.

“The low rate of use of safer first-line psychosocial treatments, such as parent-child interaction therapy or cognitive-behavioral therapy, potentially puts children at unnecessary risks associated with antipsychotic treatment,” Bushnell said to the press.2

Risks associated with antipsychotic medication for children include weight gain, sedation, diabetes, high cholesterol, cardiovascular disease, and unexpected death.

The challenge for the future, the researchers concluded, will be improving antipsychotic prescriptions in young children.


1. Bushnell GA, Crystal S, Olfson M. Trends in Antipsychotic Medication Use in Young Privately Insured Children. J Am Acad Child Adolesc Psychiatry. October 19, 2020.

2. Rutgers University. Prescriptions of Antipsychotic Medications in Young Children is Declining. News release. November 8, 2020.

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