![]() ![]() The main factors identified include a trend toward greater acceptance of psychotropic drug prescriptions in children, better knowledge of these drugs combined with an awareness of the disorders and frequency of psychological suffering in children, limited access to nonpharmacological treatments, a more pressing demand for rapid and inexpensive treatment, and a very wide disparity in time available and reimbursement rates for treatment of behavioral problems (this is particularly true in vulnerable populations in which treatment options are extremely limited in terms of supply and access to care).ĭata regarding non-U.S. The reasons for this prescription boom are summarized elsewhere (Harrison et al. ( 2012a) on changes between 19 showed that in 2009, the prevalence of antipsychotic prescriptions was 1.83% in children and 3.76% in adolescents compared to 6.18% in adults. ( 2012) distinguished age groups between 3 and 18 years and found prevalences of 0.4% between 3 and 5 years, 2.1% between 6 and 11 years, and 3.7% between 12 and 18 years. 2009) and 2.7% of prescriptions among children in the care of Child Welfare (Dosreis et al. Several estimates calculated from health insurance databases have yielded high figures: 4.2% of prescriptions among children 6–17 years of age (Crystal et al. It appears that in the United States, the prevalence of antipsychotic prescriptions is high and often does not comply with Food and Drug Administration (FDA) recommendations. In that study, more than half of the children had not been assessed by a psychiatrist. Between 20, a study found that the prevalence of prescriptions in minors rose from 0.78% to 1.58% in extremely varied indications, such as autism spectrum disorders or intellectual disability (28%), attention-deficit/hyperactivity disorder (ADHD 24%), and disruptive disorders (13%) (Olfson et al. This increase in the prescription of antipsychotics is also found among very young children (2–5 years). control authorities since psychiatrists prescribing an antipsychotic do so much more often in children (68%) and adolescents (71%) than in adults (50%) (Olfson et al. ![]() By 2009, use of atypical antipsychotics became a trend of concern worrying U.S. General context: antipsychotics in children and adolescentsĪvailable evidence shows that psychiatric consultations for children resulting in prescription of an antipsychotic notably increased about eightfold between 19 in the United States. In addition, off-label prescriptions should be limited, as they appear to account for a significant proportion of aripiprazole use worldwide. However, its use requires clinical and paraclinical monitoring to assess the occurrence of adverse events that may challenge the benefit/risk ratio. ![]() At present, postprescription monitoring is very poor.Ĭonclusion: Aripiprazole has proven efficacy for several indications in children and adolescents. Severe adverse effects often occur in multiple-prescription settings. Adverse effects are more important in children and adolescents than adults, particularly weight gain, drowsiness, extrapyramidal effects, and metabolic effects, even though the latter may appear less important than with other atypical antipsychotics. Aripiprazole has proven efficacy for several indications in children and adolescents, including schizophrenia, bipolar disorder, Tourette's syndrome, and behavioral impairments associated with autism and intellectual disability. Like others, its use in children and adolescents is becoming commonplace and occurs in off-label indications. Results: Aripiprazole is one of the most widely prescribed atypical antipsychotics. The initial screen yielded 163 publications, from which 99 studies were reviewed. Methods: Medline and Embase databases were systematically searched using the keywords aripiprazole and child or adolescent over the period from 2000 to 2019. Objective: To review the use of aripiprazole in children and adolescents.
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