Australian children and adolescents increasingly use psychotropic drugs

by Verity Leatherdale

(Medical Xpress)—More Australians, particularly children and adolescents, are using psychotropic drugs, a University of Sydney study examining prescribing patterns shows.

The study examined trends across a four-year period from the start of 2009. Its results show Australia has one of the highest rates of use in the world.

Psychotropic drugs are used to treat mood and behaviour disorders and include , antipsychotics and ADHD medications.

The most rapid percentage increases over the study period were for antidepressant and use by children aged 10-14 (35.5 percent and 49.1 percent respectively).

"While antidepressants can be very effective in treating depression in children and adolescents, most authorities recommend non-drug approaches be trialled first, especially where symptoms are of mild to moderate severity," said Emily Karanges, a PhD candidate from the University's School of Psychology and lead author of a paper on the findings just published in the Australian and New Zealand Journal of Psychiatry.

School of Psychology researchers, led by Professor Iain McGregor, note it is well established that antidepressants are less effective in depressed children and adolescents than in adults, and that there is an increased risk of self-harm and suicidal thinking when these drugs are first given to them.

In addition, very few of these drugs are comprehensively studied for their effects in children and adolescents before coming onto the market.

"We are also concerned about the increasing prescription of antidepressants of the SNRI type in Australia," said Karanges. Serotonin-noradrenaline reuptake inhibitors or SNRIs treat depression and other mood disorders.

"These tend to have more complex side effects than other antidepressants and may be more prone to causing agitation. There are few, if any, compelling reasons for SNRI antidepressants to be prescribed over other antidepressant types yet they have been very heavily marketed in recent years," said Karanges.

The study also showed that among adults, females outnumber males in their use of antidepressants by a margin of almost two to one.

Antipsychotic use jumped more than 20 percent across the study period. Antipsychotics were traditionally used to treat schizophrenia, but overall prevalence of this illness has been stable for many years.

The substantial increase in their use shows they are increasingly prescribed for problems such as anxiety, bipolar disorder, disruptive behaviour, dementia, depression and insomnia.

"This is a major concern. Antipsychotics are strong drugs with serious side effects such as obesity, diabetes and sedation, and these tend to be worse in young people. Despite this, these drugs are increasingly used in situations where other treatments may be safer and more appropriate," said Karanges.

Use of the main ADHD medication Ritalin jumped 35 percent in Australia over four years. The authors detected trends suggesting that increasing numbers of Australians are continuing to use ADHD medications beyond childhood and well into adulthood. This may reflect the increasing popularity in the diagnosis of 'Adult ADHD'.

"We need to have a national debate about what is driving this phenomenon," said Professor McGregor. "Why are we so reliant on meds for our mental wellbeing? We also need to debate whether the benefits of medication outweigh the hazards, particularly in and in those suffering only mild to moderate psychological distress."

More information: Emily A Karanges, Chris P Stephenson, and Iain S McGregor. "Longitudinal trends in the dispensing of psychotropic medications in Australia from 2009–2012: Focus on children, adolescents and prescriber specialty." Aust N Z J Psychiatry 0004867414538675, first published on June 13, 2014 DOI: 10.1177/0004867414538675

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