Potent serotonin inhibitors linked to small decline in stroke risk

Abstract

Study examines prescription of antipsychotics in youths with ADHD Much of the increase in prescribing of antipsychotics in young people has been attributable to nonindicated uses of the drugs, particularly for attentiondeficit/hyperactivity disorder (ADHD). With information limited on the factors associated with use of antipsychotics in youths with ADHD, researchers analyzed commercial insurance claims records to calculate the prevalence of antipsychotic use and to evaluate associations between clinical and demographic factors and antipsychotic prescribing. Data were collected from the Truven Health MarketScan database covering the period from 2010–2015. Records were obtained for young people ages 3 to 24 with a new diagnosis of ADHD. Youths with an antipsychotic or stimulant prescription or a diagnosis with an indication for an antipsychotic in the past 6 months were excluded. Antipsychotics were initiated in 2.6% of studied youths within a year of an ADHD diagnosis. The rate of antipsychotic treatment was highest in the youngest age group, between 3 and 5, at 4.3%. Those receiving antipsychotics were more likely to have a recent diagnosis of a comorbid psychiatric disorder (most commonly anxiety) and to have a recent inpatient psychiatric admission. Among individuals in whom antipsychotic treatment was initiated, 47.9% did not receive a prescription for a stimulant in the period between ADHD diagnosis and antipsychotic initiation. At one-year follow-up, 52.7% of youths treated with antipsychotics had received a diagnosis for which antipsychotic treatment is either indicated or has shown evidence of efficacy. “These data reveal the extent to which antipsychotics are prescribed to young people with ADHD and raise concerns regarding potential non-evidencebased antipsychotic use and underuse of stimulant medications,” study authors wrote. [Sultan R, et al. JAMA Network Open 2019; published online Jul 26; doi: 10.1001/jamanetworkopen.2019.7850]